Case Report: Convalescent Plasma, a Targeted Therapy for Patients with CVID and Severe COVID-19

The disease course of COVID-19 in patients with immunodeficiencies is unclear, as well as the optimal therapeutic strategy. We report a case of a 37-year old male with common variable immunodeficiency disorder and a severe SARS-CoV-2 infection. After administration of convalescent plasma, the patient’s condition improved rapidly. Despite clinical recovery, viral RNA remained detectable up to 60 days after onset of symptoms. We propose that convalescent plasma might be considered as a treatment option in patients with CVID and severe COVID-19. In addition, in patients with immunodeficiencies, a different clinical course is possible, with prolonged viral shedding.

[1]  James Thomas,et al.  Living Systematic Review , 2021 .

[2]  J. Babik,et al.  COVID-19 in Immunocompromised Hosts: What We Know So Far , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  Zhong Liu.  Errors in Trial of Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19. , 2020, JAMA.

[4]  Patrick W. Johnson,et al.  Safety Update , 2020, Mayo Clinic Proceedings.

[5]  R. Sanders,et al.  Anti-SARS-CoV-2 IgG from severely ill COVID-19 patients promotes macrophage hyper-inflammatory responses , 2020, bioRxiv.

[6]  E. Wood,et al.  Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. , 2020, The Cochrane database of systematic reviews.

[7]  M. M. van der Eerden,et al.  Convalescent Plasma for COVID-19. A randomized clinical trial , 2020, medRxiv.

[8]  B. Lambrecht,et al.  Correction to: Sargramostim to treat patients with acute hypoxic respiratory failure due to COVID-19 (SARPAC): A structured summary of a study protocol for a randomised controlled trial , 2020, Trials.

[9]  L. Staudt,et al.  Inhibition of Bruton tyrosine kinase in patients with severe COVID-19 , 2020, Science Immunology.

[10]  L. Ren,et al.  Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. , 2020, JAMA.

[11]  R. Hostoffer,et al.  The clinical observation of a patient with common variable immunodeficiency diagnosed as having coronavirus disease 2019 , 2020, Annals of Allergy, Asthma & Immunology.

[12]  Y. Shoenfeld,et al.  Convalescent plasma in Covid-19: Possible mechanisms of action , 2020, Autoimmunity Reviews.

[13]  C. Giaquinto,et al.  How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review , 2020, Journal of Infection.

[14]  M. Chiarini,et al.  Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover , 2020, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[15]  V. Lougaris,et al.  A possible role for B cells in COVID-19? Lesson from patients with agammaglobulinemia , 2020, Journal of Allergy and Clinical Immunology.

[16]  Jing Yuan,et al.  Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. , 2020, JAMA.

[17]  Chuan Qin,et al.  Anti-spike IgG causes severe acute lung injury by skewing macrophage responses during acute SARS-CoV infection. , 2019, JCI insight.

[18]  M. Müller,et al.  Challenges of Convalescent Plasma Infusion Therapy in Middle East Respiratory Coronavirus Infection: A Single Centre Experience , 2018, Antiviral therapy.

[19]  B. Lambrecht,et al.  Genes associated with common variable immunodeficiency: one diagnosis to rule them all? , 2016, Journal of Medical Genetics.

[20]  P. Chan,et al.  Use of convalescent plasma therapy in SARS patients in Hong Kong , 2004, European Journal of Clinical Microbiology and Infectious Diseases.