Maladies Infectieuses, HCL, 69000 Lyon, France.
Service Universitaire des Maladies Infectieuses et du Voyageurs, CH Dron, 59200 Tourcoing, France.
Infect Dis Now. 2022 Nov;52(8S):S12-S15. doi: 10.1016/j.idnow.2022.09.009. Epub 2022 Sep 13.
While immunocompromised patients are at very high risk of developing severe COVID 19, few of them have been enrolled in studies aimed at evaluating treatments. In the early stages of research on this disease, glucocorticoid therapy became the standard of care for patients requiring oxygen supplementation. It has been demonstrated that the neutralizing monoclonal antibody combination of Casirivimab and Imdevimab reduced (by 28 days) mortality in COVID-19 patients admitted to hospital who were seronegative at baseline, but not in those who were seropositive. There is still a need to determine the place of available various antivirals (Molnupiravir or Nirmatrelvir plus Ritonavir) and passive immunotherapies (Sotrovimab…) as well as convalescent plasma therapy in immunocompromised settings.
虽然免疫功能低下的患者罹患重症 COVID-19 的风险非常高，但很少有患者被纳入旨在评估治疗方法的研究中。在对这种疾病的早期研究中，糖皮质激素治疗成为需要补充氧气的患者的标准治疗方法。研究表明，Casirivimab 和 Imdevimab 的中和单克隆抗体联合用药降低了（28 天）入院时基线时血清阴性的 COVID-19 患者的死亡率，但对血清阳性的患者没有作用。目前仍需要确定各种现有抗病毒药物（Molnupiravir 或 Nirmatrelvir 加ritonavir）和被动免疫疗法（Sotrovimab…）以及恢复期血浆疗法在免疫功能低下患者中的应用地位。
