Moscow Healthcare Department, State Budgetary Healthcare Institution City Clinical Hospital, Moscow, Russia.
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation, Sechenov University, Moscow, Russia.
Hum Vaccin Immunother. 2022 Nov 30;18(6):2101334. doi: 10.1080/21645515.2022.2101334. Epub 2022 Aug 1.
The article highlights the course of long-term SARS-CoV-2 infection in a patient with a secondary immunodeficiency developed with B-cell-depleting therapy of the underlying disease. Analysis of the intrapatient virus evolution revealed an inpatient S:G75A mutation that alters the 72GTNGTKR78 motif of the S-protein, with a possible role in binding to alternative cellular receptors. Therapy with a ready-made COVID-19-globulin preparation (native human immunoglobulin G (IgG) derived from the plasma of convalescent COVID-19-patients) resulted in rapid improvement of the patient's condition, fast, and stable elimination of the virus, and passive immunization of the patient for at least 30 days. The results suggest the use of products containing neutralizing antibodies opens new prospects for treatment algorithms for patients with persistent coronavirus infection, as well as for passive immunization schemes for patients with a presumably reduced specific response to vaccination.
文章强调了继发于基础疾病的 B 细胞耗竭疗法的患者中，长期 SARS-CoV-2 感染的过程。对患者体内病毒进化的分析显示了 S 蛋白 72GTNGTKR78 基序的 S：G75A 突变，这可能与结合替代细胞受体有关。使用现成的 COVID-19 球蛋白制剂（源自 COVID-19 康复患者血浆的天然人免疫球蛋白 IgG）治疗，使患者病情迅速改善，病毒快速且稳定地消除，对患者进行至少 30 天的被动免疫。结果表明，使用含有中和抗体的产品为持续性冠状病毒感染患者的治疗方案以及对疫苗反应降低的患者的被动免疫方案提供了新的前景。
