Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany.
Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany.
Viruses. 2022 Dec 30;15(1):119. doi: 10.3390/v15010119.
Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants.
易感染人群，如免疫抑制或老年患者，在感染 SARS-CoV-2 后，COVID-19 病情严重或致死的风险较高。针对 SARS-CoV-2 的特异性单克隆抗体（mAb）或恢复期血浆的免疫疗法是保护这些患者免受严重或致死性感染的重要治疗选择。然而，单克隆抗体并非总是可用，或对新兴 SARS-CoV-2 变体的疗效较低。恢复期血浆更为常见，在低收入国家可能是一种较好的治疗选择。我们回顾性评估了在 2020 年 3 月至 2021 年 4 月期间，因缺乏 SARS-CoV-2 特异性治疗而接受 mAb 或恢复期血浆治疗的个体的结局，并将 30 天总生存率与接受支持性治疗的患者队列进行比较。我们的数据表明，mAb 治疗在预防 SARS-CoV-2 感染的严重病程方面非常有效。所有接受 mAb 治疗的患者均存活。与未接受 SARS-CoV-2 靶向治疗的患者（61%）相比，恢复期血浆治疗可将总生存率提高至 82%。我们的数据表明，早期恢复期血浆治疗可能是提高高危 COVID-19 患者总体生存率的一种选择。在其他抗病毒药物不可用或疗效明显降低的情况下，尤其是在出现新兴 SARS-CoV-2 变体时，这种方法可能更为适用。
