eprintid: 10184141
rev_number: 6
eprint_status: archive
userid: 699
dir: disk0/10/18/41/41
datestamp: 2023-12-19 10:22:19
lastmod: 2023-12-19 10:22:19
status_changed: 2023-12-19 10:22:19
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Nguyen, H
creators_name: Salkeld, J
creators_name: Agarwal, S
creators_name: Goodman, A
title: Compassionate use of REGN-COV2 in the treatment of COVID-19 in a patient with impaired humoral immunity
ispublished: pub
divisions: UCL
divisions: B02
divisions: D65
divisions: J38
keywords: Agammaglobulinemia, COVID-19, REGN-COV2, Remdesivir, SARS-CoV2
note: © 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.
abstract: 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.
date: 2021-11-01
date_type: published
publisher: Elsevier BV
official_url: https://doi.org/10.1016/j.clinpr.2021.100089
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1888265
doi: 10.1016/j.clinpr.2021.100089
medium: Print-Electronic
pii: S2590-1702(21)00026-1
lyricists_name: Goodman, Anna
lyricists_id: ALGOO97
actors_name: Goodman, Anna
actors_id: ALGOO97
actors_role: owner
funding_acknowledgements: MC_UU_00004/04 [Medical Research Council]
full_text_status: public
publication: Clinical Infection in Practice
volume: 12
article_number: 100089
event_location: England
issn: 2590-1702
citation:        Nguyen, H;    Salkeld, J;    Agarwal, S;    Goodman, A;      (2021)    Compassionate use of REGN-COV2 in the treatment of COVID-19 in a patient with impaired humoral immunity.                   Clinical Infection in Practice , 12     , Article 100089.  10.1016/j.clinpr.2021.100089 <https://doi.org/10.1016/j.clinpr.2021.100089>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10184141/1/Compassionate%20use%20of%20REGN-COV2%20in%20the%20treatment%20of%20COVID-19%20in%20a%20patient%20with%20impaired%20humoral%20immunity.pdf