Serology-based therapeutic strategy in SARS-CoV-2-infected patients
•Patients with negative serology against COVID19 due receive convalescent plasma treatment.•Patients with positive serology against COVID19 due avoid convalescent plasma treatment.•High-dose dexamethasone is necessary in patients with positive serology against COVID19.•Serology-based therapeutic str...
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| Veröffentlicht in: | International immunopharmacology 2021-12, Vol.101 (Pt B), p.108214-108214, Article 108214 |
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| creator | Garcia-Muñoz, Ricardo Farfán-Quiroga, Giovanna Ruiz-de-Lobera, Noemí Feliu, Jesus Anton-Remirez, Judith Nájera Irazu, Maria José Lisa Catón, Valentín Oteo-Revuelta, José Antonio |
| description | •Patients with negative serology against COVID19 due receive convalescent plasma treatment.•Patients with positive serology against COVID19 due avoid convalescent plasma treatment.•High-dose dexamethasone is necessary in patients with positive serology against COVID19.•Serology-based therapeutic strategy in SARS-CoV-2-infected patients is safe.•Serology-based therapeutic strategy in SARS-CoV-2-infected patients is effective.
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. |
| doi_str_mv | 10.1016/j.intimp.2021.108214 |
| format | Article |
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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.</description><identifier>ISSN: 1567-5769</identifier><identifier>ISSN: 1878-1705</identifier><identifier>EISSN: 1878-1705</identifier><identifier>DOI: 10.1016/j.intimp.2021.108214</identifier><identifier>PMID: 34649116</identifier><language>eng</language><publisher>AMSTERDAM: Elsevier B.V</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents - therapeutic use ; Antibodies ; Antibodies, Viral - blood ; B-Lymphocytes - immunology ; COVID-19 ; COVID-19 - blood ; COVID-19 - immunology ; COVID-19 - therapy ; COVID-19 Drug Treatment ; COVID-19 Serotherapy ; Depletion ; Dexamethasone ; Dexamethasone - therapeutic use ; Female ; Glucocorticoids - therapeutic use ; Humans ; Immunization, Passive ; Immunoglobulin G - blood ; Immunoglobulin M - blood ; Immunology ; Immunotherapy ; Impact analysis ; Infections ; Inflammation ; Killer Cells, Natural - immunology ; Life Sciences & Biomedicine ; Lymphocyte ; Lymphocytes ; Lymphocytes B ; Lymphocytes T ; Male ; Middle Aged ; Patients ; Pharmacology & Pharmacy ; Plasma ; Recovery ; Retrospective Studies ; SARS-CoV-2 ; SARS-CoV-2 - immunology ; Science & Technology ; Serology ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; T-Lymphocytes - immunology ; Therapy ; Tocilizumab ; Viral diseases ; Viruses</subject><ispartof>International immunopharmacology, 2021-12, Vol.101 (Pt B), p.108214-108214, Article 108214</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier BV Dec 2021</rights><rights>2021 Elsevier B.V. All rights reserved. 2021 Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>1</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000710118700002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c491t-a8fc1c5b461f315a028d6508f68d7950b52fcfbf84a83a1a4837f2ddbeaf9d7d3</citedby><cites>FETCH-LOGICAL-c491t-a8fc1c5b461f315a028d6508f68d7950b52fcfbf84a83a1a4837f2ddbeaf9d7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.intimp.2021.108214$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27929,27930,39263,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34649116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garcia-Muñoz, Ricardo</creatorcontrib><creatorcontrib>Farfán-Quiroga, Giovanna</creatorcontrib><creatorcontrib>Ruiz-de-Lobera, Noemí</creatorcontrib><creatorcontrib>Feliu, Jesus</creatorcontrib><creatorcontrib>Anton-Remirez, Judith</creatorcontrib><creatorcontrib>Nájera Irazu, Maria José</creatorcontrib><creatorcontrib>Lisa Catón, Valentín</creatorcontrib><creatorcontrib>Oteo-Revuelta, José Antonio</creatorcontrib><title>Serology-based therapeutic strategy in SARS-CoV-2-infected patients</title><title>International immunopharmacology</title><addtitle>INT IMMUNOPHARMACOL</addtitle><addtitle>Int Immunopharmacol</addtitle><description>•Patients with negative serology against COVID19 due receive convalescent plasma treatment.•Patients with positive serology against COVID19 due avoid convalescent plasma treatment.•High-dose dexamethasone is necessary in patients with positive serology against COVID19.•Serology-based therapeutic strategy in SARS-CoV-2-infected patients is safe.•Serology-based therapeutic strategy in SARS-CoV-2-infected patients is effective.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Antibodies</subject><subject>Antibodies, Viral - blood</subject><subject>B-Lymphocytes - immunology</subject><subject>COVID-19</subject><subject>COVID-19 - blood</subject><subject>COVID-19 - immunology</subject><subject>COVID-19 - therapy</subject><subject>COVID-19 Drug Treatment</subject><subject>COVID-19 Serotherapy</subject><subject>Depletion</subject><subject>Dexamethasone</subject><subject>Dexamethasone - therapeutic use</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Immunization, Passive</subject><subject>Immunoglobulin G - blood</subject><subject>Immunoglobulin M - blood</subject><subject>Immunology</subject><subject>Immunotherapy</subject><subject>Impact analysis</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Killer Cells, Natural - immunology</subject><subject>Life Sciences & Biomedicine</subject><subject>Lymphocyte</subject><subject>Lymphocytes</subject><subject>Lymphocytes B</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pharmacology & Pharmacy</subject><subject>Plasma</subject><subject>Recovery</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>SARS-CoV-2 - immunology</subject><subject>Science & Technology</subject><subject>Serology</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>T-Lymphocytes - immunology</subject><subject>Therapy</subject><subject>Tocilizumab</subject><subject>Viral diseases</subject><subject>Viruses</subject><issn>1567-5769</issn><issn>1878-1705</issn><issn>1878-1705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkVuLFDEQhRtR3Iv-A5EBX4SlxySdpNMvwtJ4gwXBUV9DOpfZDD1Jm6RX5t9bS4_j5UF8SpGccypVX1U9w2iNEeavdmsfit9Pa4IIhitBMH1QnWPRihq3iD2EmvG2Zi3vzqqLnHcIwT3Fj6uzhnLaYczPq35jUxzj9lAPKluzKrc2qcnOxetVLkkVuz2sfFhtrj9t6j5-rUntg7O6gHZSxdtQ8pPqkVNjtk-P52X15e2bz_37-ubjuw_99U2toVmplXAaazZQjl2DmUJEGM6QcFyYtmNoYMRpNzhBlWgUVlQ0rSPGDFa5zrSmuaxeL7nTPOyt0dA7qVFOye9VOsiovPzzJfhbuY13UkD_ru0g4OUxIMVvs81F7n3WdhxVsHHOkjBBBKaUEpC--Eu6i3MKMJ4knNBOsEYgUNFFpVPMOVl3-gxG8p6S3MmFkrynJBdKYHv--yAn008sIBCL4Lsdossa1qztSYYQaiEcSEOFSO8LgIihj3MoYL36f-uvlVrgdudtkkeH8QkgSxP9v0f5AfVqxic</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Garcia-Muñoz, Ricardo</creator><creator>Farfán-Quiroga, Giovanna</creator><creator>Ruiz-de-Lobera, Noemí</creator><creator>Feliu, Jesus</creator><creator>Anton-Remirez, Judith</creator><creator>Nájera Irazu, Maria José</creator><creator>Lisa Catón, Valentín</creator><creator>Oteo-Revuelta, José Antonio</creator><general>Elsevier B.V</general><general>Elsevier</general><general>Elsevier BV</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211201</creationdate><title>Serology-based therapeutic strategy in SARS-CoV-2-infected patients</title><author>Garcia-Muñoz, Ricardo ; 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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.</abstract><cop>AMSTERDAM</cop><pub>Elsevier B.V</pub><pmid>34649116</pmid><doi>10.1016/j.intimp.2021.108214</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anti-Inflammatory Agents - therapeutic use Antibodies Antibodies, Viral - blood B-Lymphocytes - immunology COVID-19 COVID-19 - blood COVID-19 - immunology COVID-19 - therapy COVID-19 Drug Treatment COVID-19 Serotherapy Depletion Dexamethasone Dexamethasone - therapeutic use Female Glucocorticoids - therapeutic use Humans Immunization, Passive Immunoglobulin G - blood Immunoglobulin M - blood Immunology Immunotherapy Impact analysis Infections Inflammation Killer Cells, Natural - immunology Life Sciences & Biomedicine Lymphocyte Lymphocytes Lymphocytes B Lymphocytes T Male Middle Aged Patients Pharmacology & Pharmacy Plasma Recovery Retrospective Studies SARS-CoV-2 SARS-CoV-2 - immunology Science & Technology Serology Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 T-Lymphocytes - immunology Therapy Tocilizumab Viral diseases Viruses |
| title | Serology-based therapeutic strategy in SARS-CoV-2-infected patients |
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