Patients with primary antibody deficiency are at risk for severe and in many cases for prolonged COVID-19. Convalescent plasma treatment of immunocompromised individuals could be an option especially in countries with limited access to monoclonal antibody therapies. While studies in immunocompetent COVID19 patients have demonstrated only a limited benefit, evidence for the safety, timing, and effectiveness of this treatment in antibody-deficient patients is lacking. Here, we describe 16 cases with primary antibody deficiency treated with convalescent plasma in four medical centers. In our cohort, treatment was associated with a reduction in viral load and improvement of clinical symptoms, even when applied over a week after onset of infection. There were no relevant side effects besides a short-term fever reaction in one patient. Longitudinal full-genome sequencing revealed the emergence of mutations in the viral genome, potentially conferring an antibody escape in one patient with persistent viral RNA shedding upon plasma treatment. However, he resolved the infection after a second course of plasma treatment. Thus, our data suggest a therapeutic benefit of convalescent plasma treatment in patients with primary antibody deficiency even months after infection. While it appears to be safe, PCR follow-up for SARS-CoV-2 is advisable and early re-treatment might be considered in patients with persistent viral shedding. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-021-01193-2.
【저자키워드】 COVID-19, convalescent plasma, SARS-CoV-2, inborn errors of immunity, Hypogammaglobulinemia, common variable immunodeficiency, Primary immunodeficiencies, 【초록키워드】 Treatment, convalescent plasma, Mutation, Clinical symptoms, antibody, monoclonal antibody, Sequencing, Infection, viral shedding, risk, Cohort, PCR, Viral load, Fever, Patient, Effectiveness, plasma, Follow-up, longitudinal, Therapies, Evidence, viral genome, Safe, deficiency, Therapeutic benefit, Side effect, Viral RNA shedding, supplementary material, immunocompromised individuals, one patient, option, convalescent plasma treatment, many cases, while, country, benefit, primary antibody, Course, applied, treated, appear, demonstrated, reduction in, resolved, COVID19 patient, immunocompromised individual, many case, 【제목키워드】 with COVID-19,