Persistent Coronavirus Disease 2019 (COVID-19) in an Immunocompromised Host Treated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-Specific Monoclonal Antibodies

Bailly, B.; Péré, Hélène; Veyer, David; Berceanu, Ana; Roux, Pauline; Hermine, Olivier; Lamballerie, Xavier de; Bastard, Paul; Lacombe, Karine; Autran, Brigitte; Delettre, Fanny Angelot; Casanova, Jean Laurent; Imbeaud, Sandrine; Clairet, Anne-Laure; Kroemer, Marie; Spehner, Laurie; Robillard, Nicolas; Puech, Julien; Marty-Quinternet, Solène; Lepiller, Quentin; Chirouze, Catherine; Bouiller, Kévin

doi:10.1093/cid/ciab868

Cited by 16 publications

(12 citation statements)

References 1 publication

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“…Notably, monoclonal antibodies were not available at our center when the patient experienced the first COVID-19 episode. Few cases of recovery after monoclonal antibodies 18,19 or convalescent plasma have been reported. 20 However, further studies are needed to assess the efficacy of these treatments to prevent COVID-19 relapses.…”

Section: Introductionmentioning

confidence: 99%

Severe relapse of SARS-CoV-2 infection in a kidney transplant recipient with negative nasopharyngeal SARS-CoV-2 RT-PCR after rituximab

Morel

Imbeaud

Scemla

et al. 2022

American Journal of Transplantation

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Immunocompromised patients may experience prolonged viral shedding after their initial SARS‐CoV‐2 infection, however, symptomatic relapses after remission currently remain rare. We herein describe a severe COVID‐19 relapse case of a kidney transplant recipient (KTR) following rituximab therapy, 3 months after a moderate COVID‐19 infection, despite viral clearance after recovery of the first episode. During the clinical relapse, the diagnosis was established on a broncho‐alveolar lavage specimen (BAL) by RT‐PCR. The infectivity of the BAL sample was confirmed on a cell culture assay. Whole genome sequencing confirmed the presence of an identical stain (Clade 20A). However, it had an acquired G142D mutation and a larger deletion of 3‐amino‐acids at position 143–145. These mutations located within the N‐terminal domain are suggested to play a role in viral entry. The diagnosis of a COVID‐19 relapse should be considered in the setting of unexplained persistent fever and/or respiratory symptoms in KTRs (especially for those after rituximab therapy), even in patients with previous negative naso‐pharyngeal SARS‐CoV‐2 PCR.

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Section: Introductionmentioning

confidence: 99%

Severe relapse of SARS-CoV-2 infection in a kidney transplant recipient with negative nasopharyngeal SARS-CoV-2 RT-PCR after rituximab

Morel

Imbeaud

Scemla

et al. 2022

American Journal of Transplantation

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“…Studies and reports have been published with different treatments, including several monoclonal antibodies, 5 immunoglobulins, remdesivir and convalescent plasma, 6 but few of them focused in immunosuppressed patients with prolonged disease courses 7 , 8 with diverse results. Although these treatments were considered, they were not prescribed on first attempt, mainly due to non-availability, difficulty in prescribing them as they were not included in the protocols and expected procoagulability.…”

Section: Discussionmentioning

confidence: 99%

Persistently positive PCR SARS-CoV-2 at low cycle threshold in an immunosuppressed patient

Martin-Díaz¹,

Cabrejas-Ugartondo²,

Iglesias-López³

et al. 2022

The Brazilian Journal of Infectious Diseases

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“…It is also present in the Omicron variant 21 . This substitution was found in two vaccinated individuals with breakthrough infection and selected in an immunocompromised individuals with chronic COVID-19 treated with convalescent plasma and monoclonal antibodies 28 29 . The T95 residue is located outside the NTD antigenic supersite and its contribution to immune evasion is poorly characterized 26 .…”

Section: Introductionmentioning

confidence: 93%

Fusogenicity and neutralization sensitivity of the SARS-CoV-2 Delta sublineage AY.4.2

Saunders

Planas

Bolland

et al. 2022

Preprint

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SARS-CoV-2 lineages are continuously evolving. As of December 2021, the AY.4.2 Delta sub-lineage represented 20 % of sequenced strains in UK and has been detected in dozens of countries. It has since then been supplanted by the Omicron variant. AY.4.2 displays three additional mutations (T95I, Y145H and A222V) in the N-terminal domain (NTD) of the spike when compared to the original Delta variant (B.1.617.2) and remains poorly characterized. Here, we analyzed the fusogenicity of the AY.4.2 spike and the sensitivity of an authentic AY.4.2 isolate to neutralizing antibodies. The AY.4.2 spike exhibited similar fusogenicity and binding to ACE2 than Delta. The sensitivity of infectious AY.4.2 to a panel of monoclonal neutralizing antibodies was similar to Delta, except for the anti-RBD Imdevimab, which showed incomplete neutralization. Sensitivity of AY.4.2 to sera from individuals having received two or three doses of Pfizer or two doses of AstraZeneca vaccines was reduced by 1.7 to 2.1 fold, when compared to Delta. Our results suggest that mutations in the NTD remotely impair the efficacy of anti-RBD antibodies. The temporary spread of AY.4.2 was not associated with major changes in spike function but rather to a partially reduced neutralization sensitivity.

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Persistent Coronavirus Disease 2019 (COVID-19) in an Immunocompromised Host Treated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-Specific Monoclonal Antibodies

Cited by 16 publications

References 1 publication

Severe relapse of SARS-CoV-2 infection in a kidney transplant recipient with negative nasopharyngeal SARS-CoV-2 RT-PCR after rituximab

Severe relapse of SARS-CoV-2 infection in a kidney transplant recipient with negative nasopharyngeal SARS-CoV-2 RT-PCR after rituximab

Persistently positive PCR SARS-CoV-2 at low cycle threshold in an immunosuppressed patient

Fusogenicity and neutralization sensitivity of the SARS-CoV-2 Delta sublineage AY.4.2

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