North-Western Tuscany Blood Bank, Pisa University Hospital, 56100 Pisa, Italy.
Division of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy.
Transfus Apher Sci. 2023 Jun;62(3):103648. doi: 10.1016/j.transci.2023.103648. Epub 2023 Jan 31.
Immunocompromised patients remain at high risk of COVID-19 morbidity and mortality. After recent Omicron sublineages gained full resistance to Evusheld™, they are left without effective pre-exposure prophylaxis. We review here arguments to support the growing role of regular immunoglobulin (IG) infusions at protecting against COVID-19. Since there is evidence for neutralizing antibody titers approaching the ones seen in hyperimmune sera, and since some categories of patients at risk for COVID-19 progression are already under preexposure prophylaxis with IG, this cost-effective strategy should be urgently investigated in randomized clinical trials. Surveys of anti-Spike antibody levels in current plasma donations are urgent to forecast the potency of future IG batches.
免疫功能低下的患者仍然面临 COVID-19 发病率和死亡率的高风险。在奥密克戎亚谱系最近完全对 Evusheld™产生耐药性后，他们没有有效的暴露前预防措施。我们在这里回顾了支持定期输注免疫球蛋白（IG）以预防 COVID-19 的论点。由于有证据表明中和抗体滴度接近高免疫血清中观察到的滴度，并且由于某些有 COVID-19 进展风险的患者群体已经在接受 IG 的暴露前预防，因此这种具有成本效益的策略应在随机临床试验中紧急研究。目前对血浆捐献物中抗刺突抗体水平的调查对于预测未来 IG 批次的效力至关重要。
