Severe Acute Respiratory Syndrome Coronavirus 2 Monoclonal Antibody Combination Therapy in Patients With Coronavirus Disease 2019 and Primary Antibody Deficiency

• Published in: The Journal of infectious diseases Vol. 225; no. 5; pp. 820 - 824
• Main Authors: Pulvirenti, Federica, Milito, Cinzia, Cinetto, Francesco, Fernandez Salinas, Ane, Terreri, Sara, Piano Mortari, Eva, Auria, Stefania, Soccodato, Valentina, Miriam, Lichtner, Nicastri, Emanuele, Vincenzi, Laura, Carsetti, Rita, D’Offizi, Gianpiero, Quinti, Isabella
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 02.03.2022
• Subjects: Antibodies; Antibodies, Monoclonal - immunology; Antibodies, Monoclonal - therapeutic use; Antibodies, Viral - immunology; Antibodies, Viral - therapeutic use; Antineoplastic Agents, Immunological; Antiviral drugs; Combination therapy; Common Variable Immunodeficiency; Coronaviruses; COVID-19; COVID-19 - drug therapy; Humans; Major and Brief Reports; Monoclonal antibodies; Patients; Polymerase chain reaction; Primary Immunodeficiency Diseases - drug therapy; Prospective Studies; Real-Time Polymerase Chain Reaction; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Standard of Care; COVID-19; SARS-CoV-2; primary antibody deficiencies; common variable immunodeficiency; monoclonal antibodies
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiab554

Abstract Background Previous reports highlighted the efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific monoclonal antibodies (mAbs) against coronavirus disease 2019. Methods We conducted a prospective study on the clinical outcome and antiviral effects of mAbs added to standard of care therapy in SARS-CoV-2-infected patients with primary antibody defects. Results Median time of SARS-CoV-2 quantitative polymerase chain reaction (qPCR) positivity was shorter in 8 patients treated with mAbs (22 days) than in 10 patients treated with standard of care therapy only (37 days, P=.026). Median time of SARS-CoV-2 qPCR positivity from mAb administration was 10 days. Conclusions The SARS-CoV-2 mAbs treatment was effective and well tolerated in patients with primary antibody defects. Anti-SARS-CoV-2 monoclonal antibodies are emerging as a potential therapeutic option for high-risk patients. Here we showed that early administration of monoclonal antibodies in patients with primary antibody defects and COVID-19 reduced the time of viral replication and avoid disease evolution.