Abstract
Immunocompromised patients, including HSCT recipients, may have a poor prognosis after contracting COVID-19 due to the absence of a pathogen-specific adaptive immune response. One of the possible options for severe COVID-19 treatment may be the transfusion of hyperimmune SARS-CoV-2 convalescent plasma. A 9-month-old girl with juvenile myelomonocytic leukemia received an HSCT from a haploidentical donor. On day +99, during routine virologic monitoring, SARS-CoV-2 was detected without any clinical symptoms. On day +144, the child developed a polysegmental bilateral viral pneumonia with 60 % damage to the lung tissue and confirm a positive SARS-Cov-2 results in throat swab. The patient was treated with tocilizumab and three doses of fresh frozen plasma obtained from a SARS-CoV-2 convalescent patient. Therapy with tocilizumab and three doses of fresh frozen plasma was well tolerated. In spite of full resolution of the lung lesions, complete elimination of SARS-CoV-2 has not been achieved 4 months after the first detection, which is due to persistence of secondary immunodeficiency after HSCT and the lack of reconstitution of the adaptive immune response. This case represents a demonstration of an atypical course of COVID-19 and the delayed development of lung lesions, which was most likely associated with the features of the patient’s immune status after HSCT. SARS-CoV-2 convalescent plasma in combination with other therapeutic approaches is one of the possible curative options for this clinical situation.
Keywords: COVID-19; Convalescent plasma; Immunocompromised patients; Pediatric; Stem cell transplantation.
【저자키워드】 COVID-19, convalescent plasma, pediatric, Immunocompromised patients, Stem cell transplantation, 【초록키워드】 Treatment, convalescent plasma, SARS-CoV-2, severe COVID-19, Clinical symptoms, Tocilizumab, Pneumonia, immunodeficiency, Immunocompromised patients, Viral pneumonia, Viral, pathogen, persistence, Child, Patient, plasma, transfusion, Adaptive immune response, patients, leukemia, convalescent patient, Donor, Immune status, Combination, Therapeutic approach, dose, Atypical, HSCT, Stem cell transplantation, stem cell, lung lesions, frozen plasma, fresh frozen plasma, myelomonocytic leukemia, poor prognosis, lung tissue, demonstration, positive, throat swab, Complete, feature, hyperimmune, HSCT recipients, Course, lack, the patient, treated, absence, pathogen-specific, curative, 【제목키워드】 SARS-CoV-2, Convalescent plasma therapy, Patient,