Early, very high-titre convalescent plasma therapy in clinically vulnerable individuals with mild COVID-19: an international, randomised, open-label trial

EBioMedicine, Journal Year: 2025, Volume and Issue: 113, P. 105613 - 105613

Published: Feb. 27, 2025

Language: Английский

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Estimates of actual and potential lives saved in the United States from the use of COVID-19 convalescent plasma

Proceedings of the National Academy of Sciences, Journal Year: 2024, Volume and Issue: 121(41)

Published: Oct. 1, 2024

In the Spring of 2020, United States America (USA) deployed COVID-19 convalescent plasma (CCP) to treat hospitalized patients. Over 500,000 patients were treated with CCP during first year pandemic. this study, we estimated number actual inpatient lives saved by treatment in based on weekly use, national mortality data, and reduction data from meta-analyses randomized controlled trials real-world data. We also estimate potential if had been for 100% or used 15 75% outpatients. Depending assumptions modeled stratified analyses, that between 16,476 66,296 lives. The ideal use might have as many 234,869 prevented 1,136,133 hospitalizations. deployment was a successful strategy ameliorating impact pandemic USA. This experience has important implications future infectious disease emergencies.

Language: Английский

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Single Monoclonal Antibodies Should Not Be Used for Coronavirus Disease 2019 Therapy: A Call for Antiviral Stewardship

Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: 79(6), P. 1404 - 1407

Published: Aug. 8, 2024

Abstract The COVID-19 pandemic witnessed the greatest deployment of monoclonal antibody (mAb) therapies for an infectious disease, but all were defeated by SARS-CoV-2 evolution. As new mAbs are developed, disease community needs stewardship practices to reduce emergence resistance.

Language: Английский

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Spike and nucleocapsid antibody dynamics following SARS‐CoV‐2 infection and vaccination: Implications for sourcing COVID‐19 convalescent plasma from routinely collected blood donations

Transfusion, Journal Year: 2024, Volume and Issue: 64(11), P. 2063 - 2074

Published: Oct. 7, 2024

Abstract Background COVID‐19 convalescent plasma (CCP) remains a treatment option for immunocompromised patients; however, the current FDA qualification threshold of ≥200 BAU/mL spike antibody appears to be relatively low. We evaluated levels binding (bAb) and neutralizing antibodies (nAb) on serial samples from repeat blood donors who were vaccinated and/or infected inform criteria qualifying CCP routinely collected components. Methods Donors categorized into four groups: (1) infected, then vaccinated, (2) during delta, or (3) omicron waves, (4) without infection. IgG Spike total Nuclecapsid bAb measured, along with S variants nAb titers using reporter viral particle neutralization. Results Mean peaks after infection alone lower than primary booster vaccinations, higher delta in previously donors. Half‐lives ranged 34 66 days first infection/vaccination events up 108 second events. The similar across different variants, except omicron, which lower. Better correlations observed at (hybrid immunity) threshold. Discussion Routine donations hybrid immunity had high potent activity 3–6 months In (>4000 BAU/mL) IgG, >95% (>500) against ancestral variant S, regardless symptoms. These findings provide basis test‐based routine donations.

Language: Английский

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Early combined therapy for COVID-19 in immunocompromised patients: a promising approach against viral persistence and drug resistance

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 28, 2025

Immunocompromised (IC) patients face significant challenges in managing COVID-19 due to their heightened susceptibility severe illness, persistent infections, and the potential development of drug resistance. Studies indicate that IC patients, particularly those with hematologic malignancies (HM), hematopoietic stem cell transplants (HSCTR), or solid organ (SOTR), experience higher mortality rates worse outcomes compared general population, even post-vaccination. The persistence virus these combined its rapid mutation, further complicates treatment. Recent evidence supports use neutralizing monoclonal antibodies (mAbs) direct-acting antivirals (DAAs) as a more effective approach viral clearance, reducing mortality, preventing relapses. However, rise resistant variants, especially mAbs, concerns about safety prolonged intensive therapies pose ongoing challenges. Monotherapies often fail short address issues, highlighting need for early therapy (ECT) mAbs DAAs. ECT has shown promise individuals by targeting multiple stages lifecycle, load, clearing infections at earlier stages, which helps mitigate risks disease Continued research is essential refine treatment protocols, evolves. Although studies are needed, current findings suggest may become standard care severely offering better clinical hindering persistence.

Language: Английский

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Antiviral combination treatment strategies for SARS-CoV-2 infection in immunocompromised patients

Current Opinion in Infectious Diseases, Journal Year: 2024, Volume and Issue: 37(6), P. 506 - 517

Published: Oct. 23, 2024

Purpose of review The purpose this is to report the available evidence regarding use combination regimens antivirals and/or antibody-based therapy in treatment SARS-CoV-2 immunocompromised patients. Recent findings Literature search identified 24 articles, excluding single case reports, which included mainly patients with hematological malignancies B-cell depletion. Data were divided based on timing and reason for administration treatment, that is, early prevent progression severe COVID-19 prolonged or relapsed infection. We described treated populations, duration composition treatment. briefly addressed new options we proposed an algorithm management infection affected by malignancies. Summary Combination seems effective (73–100%) well tolerated (<5% reported bradycardia, hepatotoxicity, neutropenia) strategy treating prolonged/relapsed infections host, although its optimal cannot be defined currently evidence. role as at a high risk disease/persistent shedding requires further from comparison monotherapy, even though efficacy was combinations plus mAbs previous viral variants.

Language: Английский

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Convalescent Plasma and Other Antibody Therapies for Infectious Diseases—Lessons Learned from COVID-19 and Future Prospects

Current topics in microbiology and immunology, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Language: Английский

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