Pneumology - Case Reports Open access

Hyperimmune plasma infusion in an immunocompromised Covid-19 patient previously treated for follicular lymphoma

Authors

Published
10 June 2021
Section
Pneumology - Case Reports
DOI
10.4081/monaldi.2021.1867

Abstract

Covid-19 in immunocompromised patients shows a prolonged course and may lead to a poor prognosis. Although data on hyperimmune plasma for treatment of Covid-19 suggest an improved outcome in immunocompetent patients, limited data are currently available in immunocompromised patients. We present the case of a 62-year-old Caucasian woman, who was previously treated with obinutuzumab and bendamustine for follicular lymphoma and showed a prolonged positive test for Covid-19. Since no improvement was observed with standard of care (including remdesivir), the possibility of hyperimmune plasma infusion was discussed. A first dose of hyperimmune plasma was administered, with subsequent onset of fever, increasing inflammatory indexes and worsening radiological findings. Three days later a second dose of plasma was administered. Within twelve hours cough and fever disappeared, and oxygen at rest was discontinued. The patient was discharged 5 days later, and nasopharyngeal swabs resulted negative 16 days after discharge.

Keywords

Supporting Agencies

None

References

  1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-3. DOI: https://doi.org/10.1056/NEJMoa2001017
  2. Karataş A, İnkaya AÇ, Demiroğlu H, et al. Prolonged viral shedding in a lymphoma patient with COVID-19 infection receiving convalescent plasma. Transfus Apher Sci 2020;59:102871. DOI: https://doi.org/10.1016/j.transci.2020.102871
  3. Dai M, Liu D, Liu M, et al. Patients with cancer appear more vulnerable to SARS-CoV-2: A multicenter study during the COVID-19 outbreak. Cancer Discov 2020;10:783-91. DOI: https://doi.org/10.1158/2159-8290.CD-20-0422
  4. Malsy J, Veletzky L, Heide J, et al. Sustained response after remdesivir and convalescent plasma therapy in a B-cell depleted patient with protracted COVID-19. Clin Infect Dis 2020:ciaa1637. Online ahead of print. DOI: https://doi.org/10.1093/cid/ciaa1637
  5. Ferrari S, Caprioli C, Weber A, et al. Convalescent hyperimmune plasma for chemo-immunotherapy induced immunodeficiency in COVID-19 patients with hematological malignancies. Leuk Lymphoma 2021;62:1490-6. DOI: https://doi.org/10.1080/10428194.2021.1872070
  6. Shah V, Ko Ko T, Zuckerman M, et al. Poor outcome and prolonged persistence of SARS-CoV-2 RNA in COVID-19 patients with hematological malignancies; King’s College Hospital experience. Br J Haematol 2020;190:e279-282. DOI: https://doi.org/10.1111/bjh.16935
  7. Choi B, Choudhary MC, Regan J, et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host. N Engl J Med 2020;383:2291-3. DOI: https://doi.org/10.1056/NEJMc2031364
  8. Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of Covid-19 - Final Report. N Engl J Med 2020;383:1813-26. DOI: https://doi.org/10.1056/NEJMc2022236
  9. Duan K, Liu B, Li C, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci USA 2020;117:9490–6. DOI: https://doi.org/10.1073/pnas.2006961117
  10. Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA 2020;323:1582-9. DOI: https://doi.org/10.1001/jama.2020.4783
  11. Libster R, Pérez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe Covid-19 in older adults. N Engl J Med 2021;384:610-8. DOI: https://doi.org/10.1056/NEJMoa2033700
  12. Wright Z, Bersabe A, Eden R, et al. Successful use of COVID-19 convalescent plasma in a patient recently treated for follicular lymphoma. Clin Lymphoma Myeloma Leuk 2021;21:66-8. DOI: https://doi.org/10.1016/j.clml.2020.06.012

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.

PlumX Metrics

License

Copyright (c) 2021 The Author(s)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.