Virology Unit, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, viale Mario Bracci, 16, Siena, Italy.
BMC Infect Dis. 2021 Jul 1;21(1):630. doi: 10.1186/s12879-021-06321-2.
Convalescent plasma (CP) and hyperimmune plasma (HP) are passive immunotherapies consisting in the infusion of plasma from recovered people into infected patients. Following pre-existing evidence in many other viral diseases, such as SARS, MERS and Ebola, CP and HP have also been proposed for the treatment of COVID-19. Nevertheless, due to the lack of large, well-designed, clinical trials, no clear-cut guidelines exist about what subtype of patient CP and HP should be administered to.
We have reported the cases of 3 patients, all immunosuppressed and affected by non-severe, prolonged COVID-19. They were treated with HP, whose neutralizing titer was higher than 1/80. The first patient was a 55-year-old male, who had undergone lung transplant. He was under therapy with Tacrolimus and developed non-neutralizing antibodies against SARS-CoV2. The second patient was a 77-year-old female, affected by follicular lymphoma. She had tested positive for SARS-CoV2 after 6 months. The third was a 60-year-old patient, affected by chronic leukemia. He did not develop antibodies after 2-month disease. All 3 patients received HP and had tested negative for SARS-CoV2 within 2 weeks.
Despite encouraging initial data, no strong evidence exist in support of CP and HP to treat COVID-19. In our experience, although limited due to the reduced number of patients, we found a good safety and efficacy of HP in 3 immuno-deficient subjects. Further data are needed in order to assess whether this subtype of patients may particularly benefit from passive immunization.
恢复期血浆（CP）和高免疫血浆（HP）是被动免疫疗法，将康复患者的血浆输注到感染患者体内。在 SARS、MERS 和埃博拉等许多其他病毒疾病中已有相关应用的先例，CP 和 HP 也被提议用于治疗 COVID-19。然而，由于缺乏大规模、精心设计的临床试验，对于 CP 和 HP 应该用于哪种类型的患者，尚无明确的指南。
我们报告了 3 例均为免疫抑制且患有非严重、迁延性 COVID-19 的患者。他们接受了 HP 治疗，其中和滴度高于 1/80。第一例患者是一名 55 岁男性，曾接受过肺移植。他正在接受他克莫司治疗，并产生了针对 SARS-CoV2 的非中和抗体。第二位患者是一位 77 岁女性，患有滤泡性淋巴瘤。她在 6 个月后患 SARS-CoV2 检测呈阳性。第三位是一位 60 岁患者，患有慢性白血病。他在发病 2 个月后未产生抗体。所有 3 例患者均接受 HP 治疗，2 周内 SARS-CoV2 检测均为阴性。
尽管有初步的令人鼓舞的数据，但没有强有力的证据支持 CP 和 HP 用于治疗 COVID-19。根据我们的经验，尽管由于患者数量较少，证据有限，但我们发现 HP 在 3 例免疫缺陷患者中具有良好的安全性和疗效。需要进一步的数据来评估这一亚组患者是否可能特别受益于被动免疫。
