Monoclonal antibodies as COVID-19 prophylaxis therapy in immunocompromised patient populations

Cowan, Juthaporn; Amson, Ashley; Christofides, Anna; Chagla, Zain

doi:10.1016/j.ijid.2023.06.021

Cited by 14 publications

(7 citation statements)

References 43 publications

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“…Our study and previous reports confirm that hybrid immunity is the best possible defence against severe COVID-19 disease and seems also to hold up for this population. Alternatively, the administration of (preventive) monoclonal antibodies against SARS-CoV-2 has been proven to be effective in immunocompromised populations, [ 11 ] however, as this strategy is beyond the scope of the present study, we will not go into further detail.…”

Section: Discussionmentioning

confidence: 99%

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Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

De Bouver,

Bouziotis,

Wijtvliet

et al. 2024

Virol J

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Background Infection with SARS-CoV-2 in high-risk groups such as kidney transplant and dialysis patients is shown to be associated with a more serious course of the disease. Four years after the start of the COVID-19 pandemic, crucial knowledge on the immune responses in these patient groups is still lacking. Therefore, this study aimed at investigating the humoral immune response after a SARS-CoV-2 infection compared to vaccination as well as the evolution of immunoglobulins over time. Methods Kidney transplant recipients, patients on haemodialysis or on peritoneal dialysis and healthy controls were included in this longitudinal multicenter study. SARS-CoV-2 anti-RBD, anti-NP and anti-S1S2 immunoglobulin G (IgG) and A (IgA) as well as the neutralizing antibody capacity were measured. Results Kidney transplant recipients had a significantly better humoral response to SARS-CoV-2 after infection (86.4%) than after a two-dose mRNA vaccination (55.8%) while seroconversion was comparable in patients on haemodialysis after infection (95.8%) versus vaccination (89.4%). In individuals without prior COVID-19, the IgG levels after vaccination were significantly lower in kidney transplant recipients when compared to all other groups. However, the IgA titres remained the highest in this patient group at each time point, both after infection and vaccination. A history COVID-19 was associated with higher antibody levels after double-dose vaccination in all patient categories and, while decreasing, titres remained high six months after double-dose vaccination. Conclusion Kidney transplant recipients had a more robust humoral response to SARS-CoV-2 following infection compared to a two-dose mRNA vaccination, while patients on haemodialysis exhibited comparable seroconversion rates. Notably, individuals with prior COVID-19 exhibited higher IgG levels in response to vaccination. Hybrid immunity is thus the best possible defence against severe COVID-19 disease and seems also to hold up for these populations. Next, it is not clear whether the higher IgA levels in the kidney transplant recipients is beneficial for neutralizing SARS-CoV-2 or if it is a sign of disease severity.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, an effective vaccination strategy is important in these populations. An alternative to vaccination is the administration of (preventive) monoclonal antibodies in case of COVID-19 with increased risk of serious infection [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

De Bouver,

Bouziotis,

Wijtvliet

et al. 2024

Virol J

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“…Accordingly, corticosteroids such as dexamethasone have beneficial effects on hospitalized patients with COVID-19 who need respiratory support [4]. Other therapies for COVID-19 such as monoclonal antibodies, anti-thrombotics, and immunotherapies are also under investigation [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Infliximab on patients with COVID-19: a systematic review and meta-analysis

Ataei,

Orandi,

Malekabad

et al. 2024

Preprint

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Despite the control of the COVID-19 pandemic, it remains one of the main concerns of healthcare systems throughout the world. Inflammation and hyper-reactive immune system play an essential role in developing SARS-CoV-2 infection, particularly in immunocompromised patients. Infliximab, an anti-TNFα antibody that is used in autoimmune disorders, may exert an important role in alleviating inflammation and hyper-reactive immunity. In this systematic review and meta-analysis, we have concluded that Infliximab can significantly decrease the mortality rate in patients with COVID-19. Conversely, it did not have a significant effect on the rate of hospitalization, mechanical ventilation, and adverse events during SARS-CoV-2 infection. More studies on the influence of Infliximab on patients with COVID-19 are warranted.

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“…Such antibodies may also help immunocompromised patients with Long COVID. 27 Additionally, Coenzyme Q 10 and D-ribose supplements have shown promise in treating Long COVID. 28 Ideally, to tackle any pandemic and its aftermath requires the availability of not only effective vaccines but also accessible effective drugs that target excessive inflammation using inexpensive repurposed generic drugs.…”

mentioning

confidence: 99%

An update on Long COVID

Grohmann,

Booy

2024

Microbiol. Aust.

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Long COVID' is a major dilemma, difficult to diagnose and even more challenging to treat. Millions are still being affected globally and ~10% of people experience Long COVID following acute infection. Many complain about fatigue, brain fog and mental difficulties, and ~200 symptoms are described making diagnosis difficult. Both acute COVID-19 and Long COVID can cause organ damage -involving the heart, lungs, kidneys, and brain; as well as inflammation, and studies suggest that severe COVID-19 is dominated by endothelial and immunological dysfunction, and immunothrombosis. Diagnostic tests for Long COVID are largely in development and finding effective therapies for Long COVID has been a major challenge; however, it is likely that antivirals have a role in preventing and treating Long COVID. Real-world data support the effectiveness of COVID-19 vaccines in reducing the risk of Long COVID. Long COVID remains a major challenge that needs considerable on-going research to determine effective treatments. The global public health emergency may be over but the fallout of Long COVID will be with us for some time.

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Monoclonal antibodies as COVID-19 prophylaxis therapy in immunocompromised patient populations

Cited by 14 publications

References 43 publications

Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

Effects of Infliximab on patients with COVID-19: a systematic review and meta-analysis

An update on Long COVID

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