Early administration of remdesivir plus convalescent plasma therapy is effective to treat COVID-19 pneumonia in B-cell depleted patients with hematological malignancies
Patients with hematological malignancies (HMs) are at a higher risk of developing severe form and protracted course of COVID-19 disease. We investigated whether the combination of viral replication inhibition with remdesivir and administration of anti-SARS-CoV-2 immunoglobulins with convalescent pla...
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| Veröffentlicht in: | Annals of hematology 2022-10, Vol.101 (10), p.2337-2345 |
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| creator | Magyari, Ferenc Pinczés, László Imre Páyer, Edit Farkas, Katalin Ujfalusi, Szilvia Diószegi, Ágnes Sik, Máté Simon, Zsófia Nagy, Gergely Hevessy, Zsuzsanna Nagy, Béla Illés, Árpád |
| description | Patients with hematological malignancies (HMs) are at a higher risk of developing severe form and protracted course of COVID-19 disease. We investigated whether the combination of viral replication inhibition with remdesivir and administration of anti-SARS-CoV-2 immunoglobulins with convalescent plasma (CP) therapy might be sufficient to treat B-cell-depleted patients with COVID-19. We enrolled 20 consecutive patients with various HMs with profound B-cell lymphopenia and COVID-19 pneumonia between December 2020 and May 2021. All patients demonstrated undetectable baseline anti-SARS-CoV-2 immunoglobulin levels before CP. Each patient received at least a complete course of remdesivir and at least one unit of CP. Previous anti-CD20 therapy resulted in a more prolonged SARS-CoV-2 PCR positivity compared to other causes of B-cell lymphopenia (
p
= 0.004). Timing of CP therapy showed a significant impact on the clinical outcome. Simultaneous use of remdesivir and CP reduced time period for oxygen weaning after diagnosis (
p
= 0.017), length of hospital stay (
p
= 0.007), and PCR positivity (
p
= 0.012) compared to patients who received remdesivir and CP consecutively. In addition, time from the diagnosis to CP therapy affected the length of oxygen dependency (
p
|
| doi_str_mv | 10.1007/s00277-022-04924-6 |
| format | Article |
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p
= 0.004). Timing of CP therapy showed a significant impact on the clinical outcome. Simultaneous use of remdesivir and CP reduced time period for oxygen weaning after diagnosis (
p
= 0.017), length of hospital stay (
p
= 0.007), and PCR positivity (
p
= 0.012) compared to patients who received remdesivir and CP consecutively. In addition, time from the diagnosis to CP therapy affected the length of oxygen dependency (
p
< 0.001) and hospital stay (
p
< 0.0001). In those cases where there were at least 10 days from the diagnosis to plasma administration, oxygen dependency was prolonged vs. patients with shorter interval (
p
= 0.006). In conclusion, the combination of inhibition of viral replication with passive immunization was proved to be efficient and safe. Our results suggest the clear benefit of early, combined administration of remdesivir and CP to avoid protracted COVID-19 disease among patients with HMs and B-cell lymphopenia.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-022-04924-6</identifier><identifier>PMID: 35836007</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antiviral drugs ; Coronaviruses ; COVID-19 ; Hematology ; Medicine ; Medicine & Public Health ; Oncology ; Original ; Original Article ; Pneumonia ; Severe acute respiratory syndrome coronavirus 2</subject><ispartof>Annals of hematology, 2022-10, Vol.101 (10), p.2337-2345</ispartof><rights>The Author(s) 2022</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-66e6785de22aa46612fffda5da76a28f9ab2a8f24bf6d58575a72b1959fd89343</citedby><cites>FETCH-LOGICAL-c451t-66e6785de22aa46612fffda5da76a28f9ab2a8f24bf6d58575a72b1959fd89343</cites><orcidid>0000-0003-0453-1709</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-022-04924-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-022-04924-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Magyari, Ferenc</creatorcontrib><creatorcontrib>Pinczés, László Imre</creatorcontrib><creatorcontrib>Páyer, Edit</creatorcontrib><creatorcontrib>Farkas, Katalin</creatorcontrib><creatorcontrib>Ujfalusi, Szilvia</creatorcontrib><creatorcontrib>Diószegi, Ágnes</creatorcontrib><creatorcontrib>Sik, Máté</creatorcontrib><creatorcontrib>Simon, Zsófia</creatorcontrib><creatorcontrib>Nagy, Gergely</creatorcontrib><creatorcontrib>Hevessy, Zsuzsanna</creatorcontrib><creatorcontrib>Nagy, Béla</creatorcontrib><creatorcontrib>Illés, Árpád</creatorcontrib><title>Early administration of remdesivir plus convalescent plasma therapy is effective to treat COVID-19 pneumonia in B-cell depleted patients with hematological malignancies</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><description>Patients with hematological malignancies (HMs) are at a higher risk of developing severe form and protracted course of COVID-19 disease. We investigated whether the combination of viral replication inhibition with remdesivir and administration of anti-SARS-CoV-2 immunoglobulins with convalescent plasma (CP) therapy might be sufficient to treat B-cell-depleted patients with COVID-19. We enrolled 20 consecutive patients with various HMs with profound B-cell lymphopenia and COVID-19 pneumonia between December 2020 and May 2021. All patients demonstrated undetectable baseline anti-SARS-CoV-2 immunoglobulin levels before CP. Each patient received at least a complete course of remdesivir and at least one unit of CP. Previous anti-CD20 therapy resulted in a more prolonged SARS-CoV-2 PCR positivity compared to other causes of B-cell lymphopenia (
p
= 0.004). Timing of CP therapy showed a significant impact on the clinical outcome. Simultaneous use of remdesivir and CP reduced time period for oxygen weaning after diagnosis (
p
= 0.017), length of hospital stay (
p
= 0.007), and PCR positivity (
p
= 0.012) compared to patients who received remdesivir and CP consecutively. In addition, time from the diagnosis to CP therapy affected the length of oxygen dependency (
p
< 0.001) and hospital stay (
p
< 0.0001). In those cases where there were at least 10 days from the diagnosis to plasma administration, oxygen dependency was prolonged vs. patients with shorter interval (
p
= 0.006). In conclusion, the combination of inhibition of viral replication with passive immunization was proved to be efficient and safe. Our results suggest the clear benefit of early, combined administration of remdesivir and CP to avoid protracted COVID-19 disease among patients with HMs and B-cell lymphopenia.</description><subject>Antiviral drugs</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Hematology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Pneumonia</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9ksGOFCEURStG47SjP-CKxI2bUqCAKjYm2o46ySSzUbfkddWjmwkFJdBt-o_8TGl7otGFbAhw73nc5DbNc0ZfMUr715lS3vct5bylQnPRqgfNiomuHuUgHjYrqjvdyroumic531HK-CD44-aik0OnKmLV_LiC5I8EptkFl0uC4mIg0ZKE84TZHVwii99nMsZwAI95xFDqDeQZSNlhguVIXCZoLY7FHZCUSEpCKGR9-_X6fcs0WQLu5xgcEBfIu3ZE78mEi8eCE1nqxIrM5LsrO7LDGUr0cetG8GQG77YBwugwP20eWfAZn93vl82XD1ef15_am9uP1-u3N-0oJCutUqj6QU7IOYBQinFr7QRygl4BH6yGDYfBcrGxapKD7CX0fMO01HYadCe6y-bNmbvsNzNOp7gJvFmSmyEdTQRn_n4Jbme28WA0H_jQsQp4eQ9I8dseczGzy6fMEDDus-FKMyq5FLxKX_wjvYv7FGo8w3vGqaZC6qriZ9WYYs4J7e_PMGpORTDnIphaBPOrCEZVU3c25SoOW0x_0P9x_QSd0bj-</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Magyari, Ferenc</creator><creator>Pinczés, László Imre</creator><creator>Páyer, Edit</creator><creator>Farkas, Katalin</creator><creator>Ujfalusi, Szilvia</creator><creator>Diószegi, Ágnes</creator><creator>Sik, Máté</creator><creator>Simon, Zsófia</creator><creator>Nagy, Gergely</creator><creator>Hevessy, Zsuzsanna</creator><creator>Nagy, Béla</creator><creator>Illés, Árpád</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0453-1709</orcidid></search><sort><creationdate>20221001</creationdate><title>Early administration of remdesivir plus convalescent plasma therapy is effective to treat COVID-19 pneumonia in B-cell depleted patients with hematological malignancies</title><author>Magyari, Ferenc ; 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We investigated whether the combination of viral replication inhibition with remdesivir and administration of anti-SARS-CoV-2 immunoglobulins with convalescent plasma (CP) therapy might be sufficient to treat B-cell-depleted patients with COVID-19. We enrolled 20 consecutive patients with various HMs with profound B-cell lymphopenia and COVID-19 pneumonia between December 2020 and May 2021. All patients demonstrated undetectable baseline anti-SARS-CoV-2 immunoglobulin levels before CP. Each patient received at least a complete course of remdesivir and at least one unit of CP. Previous anti-CD20 therapy resulted in a more prolonged SARS-CoV-2 PCR positivity compared to other causes of B-cell lymphopenia (
p
= 0.004). Timing of CP therapy showed a significant impact on the clinical outcome. Simultaneous use of remdesivir and CP reduced time period for oxygen weaning after diagnosis (
p
= 0.017), length of hospital stay (
p
= 0.007), and PCR positivity (
p
= 0.012) compared to patients who received remdesivir and CP consecutively. In addition, time from the diagnosis to CP therapy affected the length of oxygen dependency (
p
< 0.001) and hospital stay (
p
< 0.0001). In those cases where there were at least 10 days from the diagnosis to plasma administration, oxygen dependency was prolonged vs. patients with shorter interval (
p
= 0.006). In conclusion, the combination of inhibition of viral replication with passive immunization was proved to be efficient and safe. Our results suggest the clear benefit of early, combined administration of remdesivir and CP to avoid protracted COVID-19 disease among patients with HMs and B-cell lymphopenia.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35836007</pmid><doi>10.1007/s00277-022-04924-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0453-1709</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antiviral drugs Coronaviruses COVID-19 Hematology Medicine Medicine & Public Health Oncology Original Original Article Pneumonia Severe acute respiratory syndrome coronavirus 2 |
| title | Early administration of remdesivir plus convalescent plasma therapy is effective to treat COVID-19 pneumonia in B-cell depleted patients with hematological malignancies |
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