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Gharbharan A, GeurtsvanKessel CH, Jordans CCE, Blaauw M, van der Klift M, Hassing RJ, Smits-Zwinkels M, Meertens M, van den Hout EC, de Man AM, Hageman I, Bogers S, van der Schoot CE, Swaneveld F, Anas AA, Rokx C, Rijnders BJA. Effects of treatment of COVID-19 with convalescent plasma in 25 B-cell depleted patients. Clin Infect Dis 2021; 74:1271-1274. [PMID: 34293119 PMCID: PMC8406883 DOI: 10.1093/cid/ciab647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 11/14/2022] Open
Abstract
25 B-cell depleted patients (24 following anti-CD19/20 therapy) diagnosed with COVID-19, had been symptomatic for a median of 26 days but remained antibody negative. All were treated with convalescent plasma with high neutralizing antibody titers. 21 (84%) recovered, indicating the potential therapeutic effects of this therapy in this particular population.
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Affiliation(s)
- Arvind Gharbharan
- Department of Internal Medicine, Section of Infectious Diseases and department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Carlijn C E Jordans
- Department of Internal Medicine, Section of Infectious Diseases and department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marc Blaauw
- DepartmentofInternalMedicine, Elisabeth-Tweestedenhospital, Tilburg, The Netherlands
| | | | - Robert-Jan Hassing
- DepartmentofInternalMedicine, RijnstateHospital, Arnhem, The Netherlands
| | | | - Maaike Meertens
- DepartmentofIntensiveCareMedicine, OnzeLieveVrouweGasthuis, Amsterdam, The Netherlands
| | | | - Anne Marie de Man
- DepartmentofInternalMedicine, ElkerliekZiekenhuis, Helmond, The Netherlands
| | - Ilse Hageman
- DepartmentofInternalMedicine, JeroenBoschHospital, denBosch, The Netherlands
| | - Susanne Bogers
- DepartmentofViroscience, ErasmusMC, Rotterdam, The Netherlands
| | | | - Francis Swaneveld
- UnitofTransfusionMedicine, SanquinBloodSupply, Amsterdam, The Netherlands
| | - Adam A Anas
- Department of Internal Medicine, Section of Infectious Diseases and department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Casper Rokx
- Department of Internal Medicine, Section of Infectious Diseases and department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Bart J A Rijnders
- Department of Internal Medicine, Section of Infectious Diseases and department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Guevara-Hoyer K, Gil C, Parker AR, Williams LJ, Orte C, Rodriguez de la Peña A, Ochoa-Grullón J, Rodriguez De Frias E, García IS, García-Gómez S, Recio MJ, Fernández-Arquero M, Pérez de Diego R, Ramos JT, Sánchez-Ramón S. Measurement of Typhim Vi IgG as a Diagnostic Tool to Determine Anti-polysaccharide Antibody Production Deficiency in Children. Front Immunol 2019; 10:654. [PMID: 31001267 PMCID: PMC6455213 DOI: 10.3389/fimmu.2019.00654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The assessment of specific polysaccharide antibody production plays a pivotal role in the diagnosis of humoral primary immunodeficiencies (PID). The response to 23-valent pneumococcal vaccine (PPV) remains the gold standard for the diagnosis of polysaccharide antibodies. However, in Spain, the interpretation of pure polysaccharide 23-valent immunization is hampered by the high endemicity of pneumococcal disease and the generalization of the 13-valent adjuvant pneumococcal vaccination. Specific Typhim Vi vaccination (TV) immunoglobulin G IgG response to immunization is useful in adult PID, but there is no data regarding children. Objectives: To evaluate the clinical utility of TV IgG production as a diagnostic tool to determine anti-polysaccharide antibody production deficiency in children, when the response to PPV is unclear and isolated determination of serotypes is unfeasible. Methods: We conducted a single-institution prospective observational study on 61 children with recurrent infections. Baseline specific antibodies against PPV and TV were evaluated. In 28 children (46%), the response to the production of antibodies confirmed a clinical suspicion of humoral PID, and they were therefore immunized with 23-valent pneumococcal vaccine and Typhim Vi. Both specific antibody responses were measured by ELISA (The Binding Site Group Ltd, Birmingham, UK) using previously published cut-offs. Results: Seventy percent of the 61 children displayed baseline PPV IgG > 27 mg/L, whereas only 8% showed TV IgG > 28 U/mL (p < 0.0001). Twenty-one of 28 children (75%) achieved a 3-fold increase in post-vaccination TV IgG levels, whereas only 3% achieved a 4-fold increase in PPV IgG post vaccination, mainly due to high baseline PPV IgG titers. When we classified children according to their response to TV as responders or non-responders and compared this with the well-known clinical warning signs of the Jeffrey Modell Foundation. The proportions of children with history of pneumonia and the need for intravenous antibiotics were significantly higher in TV IgG non-responders than in TV IgG responders (p = 0.02 and p = 0.01, respectively). Conclusion: Response to TV can be considered an ancillary diagnostic tool to determine polysaccharide antibodies in children, particularly when isolated determination of pneumococcal serotypes is not feasible. TV provides a useful asset for clinicians in the era of conjugate PPV vaccination, with clinical relevance. Further research is warranted for validation.
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Affiliation(s)
- Kissy Guevara-Hoyer
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Celia Gil
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Carmen Orte
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Juliana Ochoa-Grullón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | | | - Irene Serrano García
- Department of Epidemiology and Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - Sonia García-Gómez
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain.,Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - M José Recio
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Miguel Fernández-Arquero
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Rebeca Pérez de Diego
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain.,Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Jose Tomas Ramos
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Silvia Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
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