Bez Patrick, D'ippolito Giancarlo, Deiana Carla Maria, Finco Gambier Renato, Pica Andrea, Costanzo Giulia, Garzi Giulia, Scarpa Riccardo, Landini Nicholas, Cinetto Francesco, Firinu Davide, Milito Cinzia
Rare Diseases Referral Center, Internal Medicine 1, Ca' Foncello Hospital-AULSS2 Marca Trevigiana, 31100 Treviso, Italy.
Department of Medicine-DIMED, University of Padova, 35122 Padua, Italy.
Life (Basel). 2023 Jul 8;13(7):1530. doi: 10.3390/life13071530.
The SARS-CoV-2 infection is now a part of the everyday lives of immunocompromised patients, but the choice of treatment and the time of viral clearance can often be complex, exposing patients to possible complications. The role of the available antiviral and monoclonal therapies is a matter of debate, as are their effectiveness and potential related adverse effects. To date, in the literature, the amount of data on the use of combination therapies and on the multiple lines of anti-SARS-CoV-2 therapy available to the general population and especially to inborn error of immunity (IEI) patients is small.
Here, we report a case series of five adult IEI patients managed as inpatients at three Italian IEI referral centers (Rome, Treviso, and Cagliari) treated with combination therapy or multiple therapeutic lines for SARS-CoV-2 infection, such as monoclonal antibodies (mAbs), antivirals, convalescent plasma (CP), mAbs plus antiviral, and CP combined with antiviral.
This study may support the use of combination therapy against SARS-CoV-2 in complicated IEI patients with predominant antibody deficiency and impaired vaccine response.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染如今已成为免疫功能低下患者日常生活的一部分，但治疗方案的选择以及病毒清除时间往往较为复杂，使患者面临可能出现的并发症。现有抗病毒疗法和单克隆抗体疗法的作用存在争议，其有效性和潜在相关不良反应也是如此。迄今为止，在文献中，关于联合疗法的使用以及普通人群尤其是先天性免疫缺陷（IEI）患者可用的多条抗SARS-CoV-2治疗线的数据量较少。
在此，我们报告了一个病例系列，包括五名成年IEI患者，他们在意大利的三个IEI转诊中心（罗马、特雷维索和卡利亚里）住院治疗，接受了联合疗法或多条治疗线治疗SARS-CoV-2感染，如单克隆抗体（mAbs）、抗病毒药物、康复期血浆（CP）、mAbs加抗病毒药物以及CP联合抗病毒药物。
本研究可能支持在具有主要抗体缺陷和疫苗反应受损的复杂IEI患者中使用联合疗法对抗SARS-CoV-2。
