A Descriptive, Retrospective Analysis of COVID-19 Passive Antibody Therapy and Its Effects on Morbidity and Mortality in Patients Receiving B-Cell-Depleting Therapies
Author:
Gentile Sonia12, Sullivan Liam R.23, Brooks Heather4, Simeunovic Gordana23ORCID
Affiliation:
1. Department of Internal Medicine and Pediatrics, Corewell Health, Grand Rapids, MI 49503, USA 2. College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA 3. Department of Infectious Disease, Corewell Health, Grand Rapids, MI 49503, USA 4. Office of Research and Education, Corewell Health, Grand Rapids, MI 49503, USA
Abstract
Patients receiving B-cell-depleting therapies (BCDT) are at an increased risk for severe COVID-19. Passive antibody therapy (PAT), including COVID-19 convalescent plasma (CCP) and monoclonal antibodies (mAb), may be an effective treatment in this population. Real-world data on PAT effectiveness are limited. To evaluate response to PAT measured through 90-day all-cause morbidity and mortality, we performed a retrospective review of patients who contracted COVID-19 within a year from the last BCDT. From 64 included patients, the majority were Caucasians (95%), female (56%), vaccinated (67%), treated outpatients (64%), with multiple comorbidities. Examined BCDT were rituximab (55%), obinutuzumab (33%), ocrelizumab (11%) and ofatumumab (1%), used for underlying hematological malignancy (HEM) (40%), multiple sclerosis (34%), and rheumatoid arthritis (16%). Of seven deceased patients, three died from COVID-19. All three were elderly males with multiple comorbidities, treated inpatient for severe COVID-19. Four of 41 patients treated as outpatients were hospitalized for non-COVID-19-related reasons. All deceased and hospitalized patients had an underlying HEM. All but one were on rituximab. PAT may be an effective treatment for patients receiving BCDT, especially if given early for non-severe disease. Patients with underlying HEM may be at increased risk for severe disease compared with others receiving the same BCDT.
Reference37 articles.
1. Mathieu, E., Ritchie, H., Rodés-Guirao, L., Appel, C., Giattino, C., Hasell, J., Macdonald, B., Dattani, S.-L., Beltekian, D., and Ortiz-Ospina, E. (2023, December 08). Coronavirus Pandemic (COVID-19) 2020. Available online: https://ourworldindata.org/coronavirus. 2. B cells as antigen presenting cells;Cell. Immunol.,2005 3. Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: Half of patients respond to a four-dose treatment program;McLaughlin;J. Clin. Oncol.,1998 4. COVID-19 in Patients Receiving CD20-depleting Immunochemotherapy for B-cell Lymphoma;Gaitzsch;HemaSphere,2021 5. Terpos, E., Gavriatopolous, M., Fotiou, D., Giatra, C., Asimakopoulos, I., Dimou, M., Sklirou, A.D., Ntanasis-Stathopoulos, I., Darmani, I., and Briasoulis, A. (2021). Poor neutralizing antibody responses in 132 patients with CLL, NHL and HL after vac-cination against SARS-CoV-2: A prospective study. Cancers, 13.
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