Infectious Diseases Department, Hospital Regional Universitario de Málaga, Spain.
Centro de Transfusión, Tejidos y Células (CTTC), Málaga, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2022 Nov;40(9):507-516. doi: 10.1016/j.eimce.2021.01.009.
Patients lacking humoral response have been suggested to develop a less severe COVID-19, but there are some reports with a prolonged, relapsing or deadly course. From April 2020, there is growing evidence on the benefits of COVID-19 convalescent plasma (CCP) for patients with humoral immunodeficiency. Most of them had a congenital primary immunodeficiency or were on treatment with anti CD20 antibodies. We report on three patients treated in our hospital and review thirty-one more cases described in the literature. All patients but three resolved clinical picture with CCP. A dose from 200 to 800ml was enough in most cases. Antibody levels after transfusion were negative or low, suggesting consumption of them in SARS-CoV-2 neutralization. These patients have a protracted clinical course shortened after CCP. CCP could be helpful for patients with humoral immunodeficiency. It avoid relapses and chronification. CCP should be transfused as early as possible in patients with COVID-19 and humoral immunodeficiency.
有研究表明，缺乏体液免疫反应的患者 COVID-19 病情较轻，但也有一些报告显示，这些患者的病程迁延、复发或致命。自 2020 年 4 月以来，COVID-19 恢复期血浆（CCP）对体液免疫缺陷患者有益的证据越来越多。这些患者大多存在先天性原发性免疫缺陷，或正在接受抗 CD20 抗体治疗。我们报告了我院治疗的 3 例患者，并复习了文献中描述的 31 例更多病例。除了 3 例患者以外，所有患者的临床症状均通过 CCP 得到缓解。大多数患者使用了 200 至 800ml 的剂量。输注后的抗体水平为阴性或较低，提示其在 SARS-CoV-2 中和作用中被消耗。这些患者在接受 CCP 治疗后，病程迁延的情况有所改善。CCP 可能对体液免疫缺陷患者有帮助。它可以避免复发和慢性化。对于 COVID-19 合并体液免疫缺陷的患者，应尽早输注 CCP。
