1. Antibody response and intra‐host viral evolution after plasma therapy in <scp>COVID</scp> ‐19 patients pre‐exposed or not to B‐cell‐depleting agents
- Author
-
David Gachoud, Trestan Pillonel, Gerasimos Tsilimidos, Dunia Battolla, Dominique Dumas, Onya Opota, Stefano Fontana, Peter Vollenweider, Oriol Manuel, Gilbert Greub, Claire Bertelli, and Nathalie Rufer
- Subjects
SARS-CoV-2 ,Immunoglobulin G ,Antibody Formation ,Immunization, Passive ,Humans ,COVID-19 ,Hematology ,Antibodies, Viral - Abstract
Administration of plasma therapy may contribute to viral control and survival of COVID-19 patients receiving B-cell-depleting agents that impair humoral immunity. However, little is known on the impact of anti-CD20 pre-exposition on the kinetics of SARS-CoV-2-specific antibodies. Here, we evaluated the relationship between anti-spike immunoglobulin G (IgG) kinetics and the clinical status or intra-host viral evolution after plasma therapy in 36 eligible hospitalized COVID-19 patients, pre-exposed or not to B-cell-depleting treatments. The majority of anti-CD20 pre-exposed patients (14/17) showed progressive declines of anti-spike IgG titres following plasma therapy, contrasting with the 4/19 patients who had not received B-cell-depleting agents (p = 0.0006). Patients with antibody decay also depicted prolonged clinical symptoms according to the World Health Organization (WHO) severity classification (p = 0.0267) and SARS-CoV-2 viral loads (p = 0.0032) before complete virus clearance. Moreover, they had higher mutation rates than patients able to mount an endogenous humoral response (p = 0.015), including three patients with one to four spike mutations, potentially associated with immune escape. No relevant differences were observed between patients treated with plasma from convalescent and/or mRNA-vaccinated donors. Our study emphasizes the need for an individualized clinical care and follow-up in the management of COVID-19 patients with B-cell lymphopenia.
- Published
- 2022
- Full Text
- View/download PDF