COVID-19 neutralizing antibody-based therapies in humoral immune deficiencies: A narrative review

Potential use of convalescent plasma for SARS-CoV-2 prophylaxis and treatment in immunocompromised and vulnerable populations

“…In a single center cohort of patients with chronic lymphocytic leukemia and symptomatic COVID-19, 7 of 21 (33%) did not develop detectable anti-SARS-CoV-2 antibodies, markedly lower than the 100% seroconversion rate observed in a non-cancer population [33,34]. Immunocompromised patients suffering from oncohematological cancers, due to their inability to mount an appropriate humoral immune response to SARS-CoV-2, represent the ideal candidate for passive immunotherapy by means of CCP transfusion [35]. There is increasing interest toward the CCP use in patients with hematologic malignancies and several investigators have explored this therapeutic possibility [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55].…”

“…Among patients with hematological malignancies, those suffering from lymphoproliferative B-cell disorders or receiving B-cell depleting therapies are the ones who are likely to benefit most from CCP therapy. Such patients, indeed, are unable to mount an adequate immune response against SARS-CoV-2 and thus may benefit from the passive transfer of anti-SARS-CoV-2 antibodies through CCP transfusion administered during the early phase of viral infection [35]. Many case reports and cases series have also shown clinical benefit in congenital immune deficiencies, particularly those with genetically determined impaired humoral response.…”

The Three Pillars of COVID-19 Convalescent Plasma Therapy

“…On a rational basis, CP should have it maximum efficacy in patients with an impaired humoral response against COVID-19 [26]. Indeed, there are several reports on CP clinical benefit in such patients, including those with solid and hematologic cancers and with acquired and congenital immune deficiencies [31]. In particular, a recent systematic review reported positive outcomes following CP infusion in 14 COVID-19 pediatric patients, wherein five of them suffered from congenital immuno-deficiency or onco-hematologic disorders [32].…”

Anti-SARS-CoV-2 and anti-cytokine storm neutralizing antibody therapies against COVID-19: Update, challenges, and perspectives

“…At the onset of the pandemic, the predominant strategies involved using available medicines to treat or even prevent infection. This strategy had a misleading success at the beginning, as some chemical compounds tested in vitro and in vivo presented evidence of early treatment and prophylaxis [31] , such as the promising and novel use of clofazimine [32] and molnupiravir [33] , as well as compounds that have already used for similar applications, such as chloroquine (CLO), hydroxychloroquine (HCLO), ivermectin, azithromycin and some others [8] , including ABT [34] , [35] , [36] , [37] , [38] .…”

“…ABT passive immunotherapy is based on nAbs to keep pathogens from entering the host cell. ABT can be divided into five categories: convalescent plasma (CP), intravenous immunoglobulin (IVIG), intravenous hyperimmune immunoglobulin (IVHI), monoclonal antibodies (mAbs) – alone or in cocktails – and nanobodies [34] , [35] , [36] , [37] , [38] . Major nAbs against SARS-CoV-2 act against the S glycoprotein RBD [42] .…”