Case Report: Effects of Anti-SARS-CoV-2 Convalescent Antibodies Obtained With Double Filtration Plasmapheresis

Front Immunol. 2021 Jun 30:12:711915. doi: 10.3389/fimmu.2021.711915. eCollection 2021.

Abstract

Passive antibody therapy has been used to treat outbreaks of viral disease, including the ongoing pandemic of severe respiratory acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) or COVID-19. However, the real benefits of the procedure are unclear. We infused a concentrated solution of neutralizing anti-SARS-CoV-2 antibodies obtained from a convalescent donor with a single session of double filtration plasmapheresis (DFPP) into a 56-year-old woman with long history of unremitting, severe COVID-19. She was unable to establish an adequate antiviral immune response because of previous chemotherapy, including the infusion of the anti-CD20 monoclonal antibody rituximab, administered to treat a diffuse large B-cell lymphoma. The disease promptly recovered despite evidence of no endogenous anti-SARS-CoV-2 antibody production. The observation that passive antibody therapy might prove particularly effective in immunodepressed COVID-19 patients requires evaluation in prospective randomized controlled trial.

Keywords: COVID-19; case report; coagulation biomarkers; convalescent antibodies; double filtration plasmapheresis; hypercoagulability; immunosuppression; rituximab.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing / therapeutic use*
  • Antibodies, Viral / therapeutic use*
  • Antineoplastic Agents, Immunological / adverse effects
  • Antiviral Agents / therapeutic use
  • COVID-19 / immunology
  • COVID-19 / therapy*
  • COVID-19 / virology
  • COVID-19 Serotherapy
  • Female
  • Humans
  • Immunity / drug effects
  • Immunization, Passive / methods*
  • Immunocompromised Host*
  • Immunoglobulin G / therapeutic use*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Middle Aged
  • Plasmapheresis / methods*
  • RNA, Viral / genetics
  • Rituximab / adverse effects
  • SARS-CoV-2 / genetics*
  • Treatment Outcome

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Antineoplastic Agents, Immunological
  • Antiviral Agents
  • Immunoglobulin G
  • RNA, Viral
  • Rituximab