Serology-based therapeutic strategy in SARS-CoV-2-infected patients.

Autor: Garcia-Muñoz R; Hematology Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: rgmunoz@riojasalud.es., Farfán-Quiroga G; Hematology Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: gfarfan@riojasalud.es., Ruiz-de-Lobera N; Emergency Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: nrlobera@riojasalud.es., Feliu J; Hematology Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: jfeliusa@yahoo.es., Anton-Remirez J; Department of Physical Medicine and Rehabilitation. Complejo Hospitalario de Navarra, Pamplona, Spain. Electronic address: jarenero@outlook.es., Nájera Irazu MJ; Hematology Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: mjnajera@riojasalud.es., Lisa Catón V; Emergency Department, Hospital San Pedro, Logroño, La Rioja, Spain. Electronic address: vlisa@riojasalud.es., Oteo-Revuelta JA; Infectious Diseases Department, Hospital San Pedro, Logroño, La Rioja. C/Piqueras 98, PC 26006, Spain. Electronic address: jaoteo@riojasalud.es.
Jazyk: angličtina
Zdroj: International immunopharmacology [Int Immunopharmacol] 2021 Dec; Vol. 101 (Pt B), pp. 108214. Date of Electronic Publication: 2021 Oct 05.
DOI: 10.1016/j.intimp.2021.108214
Abstrakt: SARS-CoV-2 infection can be a life-threatening disease. The optimal treatment of patients is not yet standardized. We use a serology-based therapeutic strategy based on the presence of antibodies against the SARS-CoV-2 virus, in which patients with positive serology receive aggressive anti-inflammatory treatment with high-dose dexamethasone and/or tocilizumab and patients with negative serology receive early convalescent plasma therapy. We also analyze the immunological impact of this therapy in the recovery of T cells, B cells and NK cells during hospitalization in a COVID-19 infectious ward. Our results suggest that aggressive therapy with early administration of convalescent plasma and high-dose dexamethasone may be of benefit in patients with SARS-CoV-2 infection and might avoid progression of lung damage or need of admission in intensive care. This strategy did not impair immune responses against SARS-CoV-2, as 93% of the patients generated antibodies against the virus. Independently of previous immunological status of the patients, serology-guided therapy might benefit even patients with a high CIRS-G score, immunosuppressed or medically debilitated individuals and elderly patients. T cell disturbances were most frequent in patients who required high-dose dexamethasone, and B cell depletion was most frequent in patients who received tocilizumab. Early passive immunotherapy with convalescent plasma does not affect lymphoid recovery.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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