Currently Available Intravenous Immunoglobulin Contains Antibodies Reacting Against Severe Acute Respiratory Syndrome Coronavirus 2 Antigens

Díez, José-María; Romero, Carolina; Gajardo, Rodrigo

doi:10.2217/imt-2020-0095

Cited by 82 publications

(81 citation statements)

References 28 publications

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“…Intravenous gammaglobulins (IVIG) serve as an anti-inflammatory rescue therapy in autoimmune diseases although the precise mode of action is elusive. In addition, commercially available IVIG preparations contain antibodies cross-reactive to SARS CoV-2 or endogenous proteins, such as cytokines ( 156 ). Therefore, IVIG have been used in COVID-19 ( 157 – 159 ).…”

Section: Should We Use Dmards For the Therapy Of Covid-19?mentioning

confidence: 99%

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

et al. 2020

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In December 2019, a cluster of severe pneumonia was observed in China, with the subsequent discovery of a new beta-coronavirus (SARS-CoV-2) as the causative agent. The elicited disease COVID-19 is characterized by fever, dry cough, myalgia, or fatigue and has a favorable outcome in the majority of cases. However, in some patients COVID-19 leads to severe pneumonia and sepsis with subsequent respiratory failure and gastrointestinal, hematological, neurological, and cardiovascular complications. A higher risk of infection is intrinsic to active rheumatic and musculoskeletal diseases (RMD) and the use of biological disease modifying anti-rheumatic drugs (DMARDs). With an increasing number of reports on COVID-19 in RMD patients, we are beginning to appraise their risks. In this review, we summarize the published cases of COVID-19 infections in RMD patients, including patients with inflammatory arthritis and connective tissue diseases as well as anti-phospholipid syndrome and Kawasaki syndrome. Overall, patients with inflammatory arthritis do not seem to be at a higher risk for infection or a severe course of COVID-19. Risk for critical COVID-19 in patients with systemic inflammatory diseases such as SLE or vasculitis might be increased, but this needs further confirmation. Furthermore, we summarize the data on DMARDs used to fight SARS-CoV-2 infection and hyperinflammation.

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Section: Should We Use Dmards For the Therapy Of Covid-19?mentioning

confidence: 99%

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

et al. 2020

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“…Similarly, immune history has been shown to profoundly affect protective B cell responses to influenza [66]. Since we detected pan-CoV cross-reactive antibodies less frequently in plasma samples from adult donors, our results argue against a strong therapeutic benefit of intravenous immunoglobulin products to control the spread of COVID-19 disease [67]. In this context, it should be noted that large-scale antibody screening by PhIP-Seq may frequently fail to detect conformational and posttranslationally modified B cell epitopes [29].…”

Section: Discussionmentioning

confidence: 57%

Distinct antibody repertoires against endemic human coronaviruses in children and adults

Khan

Rahman

Ali

et al. 2020

Preprint

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19Four endemic human coronaviruses (HCoVs) are commonly associated with acute respiratory 20 infection in humans but immune responses to these "common cold" viruses remain 21 incompletely understood. Moreover, there is evidence emerging from independent studies 22 which suggests that endemic HCoVs can induce broadly cross-reactive T cell responses and 23 may thereby affect clinical outcomes of acute infections with the phylogenetically related 24 epidemic viruses, namely MERS-CoV and SARS-CoV-2. Here we report a comprehensive 25 retrospective analysis of CoV-specific antibody specificities in a large number of samples from 26 children and adults using Phage-Immunoprecipitation Sequencing (PhIP-Seq). We estimate 27 the seroprevalence for endemic HCoVs to range from ~4% to ~27% depending on species and 28 cohort. Most importantly, we identified a large number of novel linear B cell epitopes of HCoV 29 proteins and demonstrate that antibody repertoires against endemic HCoVs are qualitatively 30 different in children in comparison to the general adult population and healthy adult blood 31 bank donors. We show that anti-HCoV IgG specificities more frequently found among children 32 target functionally important and structurally conserved regions of the HCoV spike and 33 nucleocapsid proteins and some antibody specificities are broadly cross-reactive with 34 peptides of epidemic human and non-human coronavirus isolates. Our findings shed light on 35 the humoral immune responses to natural infection with endemic HCoVs and may have 36 important implications for understanding of the highly variable clinical outcomes of human 37 coronavirus infections, for the development of prophylactic or therapeutic monoclonal 38 antibodies and vaccine design. 39 parainfluenza viruses (HPIVs), albeit with differences in seasonality and prevalence of the 48 viruses depending on the species [5-7]. In addition to the four endemic HCoV, three epidemic 49 coronaviruses (CoVs) have emerged in humans over the last two decades, including Severe 50 Acute Respiratory Syndrome-associated CoV (SARS-CoV) [8], Middle East Respiratory 51

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“…Such disorders have increasingly been reported also to COVID-19 [1][2][3][4][5]. Recently, two marketed IVIG products were shown to react with SARS-CoV 2 antigens in vitro [6]. In line with all this, there have been case reports of COVID-19 patients who bene ted from IVIG treatment [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 81%

Effects of Intravenous Immunoglobulin on the Course of Severe COVID-19: Results From a Retrospective Data Analysis of a Patient Cohort in Turkey Treated With or Without Octagam®

Esen¹,

Özcan²,

Orhun³

et al. 2020

Preprint

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Background: There is some evidence from case reports and a few studies in China that critically ill COVID-19 patients may benefit from treatment with intravenous immunoglobulins (IVIG). We compared clinical outcomes and biomarkers in a Turkish cohort of patients with severe COVID-19 who were treated with the institution's standard of care (SOC), either alone or in combination with IVIG.Methods: Data from COVID-19 patients treated in two intensive care units at the University hospital of Istanbul was analyzed retrospectively. Patients received preliminary SOC according to the institution's treatment algorithm, to which Octagam 5% at 30 g/day for 5 days was added in one of the two wards. Both groups were compared regarding baseline characteristics, survival, and changes in inflammation markers (C-reactive protein=CRP, ferritin, procalcitonin, interleukin-6, D‑dimer, leukocytes). Imbalance in baseline APACHE II scores was addressed by propensity-score-matching; otherwise Kaplan-Meier and multiple logistic regression models were used.Results: Data from 93 patients was analyzed, 51 had received IVIG and 42 had not. About 75% of patients were male and both groups had comparable body mass index (BMI) and blood group distribution. IVIG-treated patients were younger (means 65 vs. 71 years) and had slightly lower baseline disease scores (APACHE II: 20.6 vs. 22.4; SOFA: 5.0 vs. 7.0). Overall survival (OS) was 61% in the IVIG and 38% in the control group. After controlling for imbalances at baseline, there was still a trend for better OS (OR: 2.2, 95%CI: 0.9-5.4, p=0.091) and a significantly longer median survival time with IVIG (68 vs. 18 days, p=0.014). IVIG significantly reduced CRP levels, but had no relevant effect on other inflammation markers.Conclusion: Adjunct treatment with IVIG might add to the COVID-19 armamentarium, but results need to be confirmed in a randomized, controlled trial.

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Currently Available Intravenous Immunoglobulin Contains Antibodies Reacting Against Severe Acute Respiratory Syndrome Coronavirus 2 Antigens

Cited by 82 publications

References 28 publications

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

Distinct antibody repertoires against endemic human coronaviruses in children and adults

Effects of Intravenous Immunoglobulin on the Course of Severe COVID-19: Results From a Retrospective Data Analysis of a Patient Cohort in Turkey Treated With or Without Octagam®

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