TY  - JOUR
TI  - Compassionate use of REGN-COV2 in the treatment of COVID-19 in a patient with impaired humoral immunity
VL  - 12
AV  - public
Y1  - 2021/11/01/
N1  - © 2021 The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY-NC-ND.
ID  - discovery10184141
N2  - Background: The role of antibodies in coronavirus disease 2019 (COVID-19) in patients with X-linked agammaglobulinaemia (XLA) has yet to be characterised and clinical courses observed in this cohort of patients have been heterogeneous. Whilst some exhibit spontaneous recovery, others have experienced a more protracted disease length. Previous reports have described successful use of convalescent plasma, however there is a paucity of information around the use of the REGN-COV2 antibody cocktail in these patients. Case report: A patient with XLA was admitted to hospital with COVID-19 and remained persistently symptomatic with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab positivity despite treatment with Remdesivir and dexamethasone. Attempts at modulating the immune response with anakinra were unsuccessful. Consent for compassionate use of REGN-COV2 was obtained with administration taking place on day 87 of his illness. This was followed by a period of convalescence and SARS-CoV-2 nasopharyngeal swab negativity. As a consequence of prolonged immunosuppression, the patient developed pneumocystis pneumonia. Conclusion: This case highlights the role of antibodies in clearing SARS-CoV-2 in a hypogammaglobulinaemic host and demonstrates the consequences of prolonged immunosuppression and delayed treatment. We propose that this may be of particular significance given the capacity of SARS-CoV-2 to develop advantageous mutations in a chronically infected host.
SN  - 2590-1702
PB  - Elsevier BV
UR  - https://doi.org/10.1016/j.clinpr.2021.100089
JF  - Clinical Infection in Practice
KW  - Agammaglobulinemia
KW  -  COVID-19
KW  -  REGN-COV2
KW  -  Remdesivir
KW  -  SARS-CoV2
A1  - Nguyen, H
A1  - Salkeld, J
A1  - Agarwal, S
A1  - Goodman, A
ER  -