open access

Vol 6, No 2 (2021)
Case report
Published online: 2021-04-16
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Minimally reduced levels of anti-Spike IgG after nine COVID-19 convalescent plasma donations: a case report

Tomasz Wasiluk1, Kamila Rybinska1, Anna Rogowska1, Barbara Boczkowska-Radziwon1, Piotr Radziwon12
DOI: 10.5603/MRJ.a2021.0017
·
Medical Research Journal 2021;6(2):157-160.
Affiliations
  1. Regional Centre for Transfusion Medicine in Bialystok
  2. Department of Hematology, Medical University of Bialystok, Poland

open access

Vol 6, No 2 (2021)
CASE REPORTS
Published online: 2021-04-16

Abstract

Despite intensive research, the physiology of the serological response to SARS-CoV-2 infection and its dynamics during the recovery period remain incompletely understood. Regulation of the immune response seems all the more important as it plays a role in both virus clearance during infection and the potential development of long-term resistance to reinfection. A case of convalescent plasma donor is described in whom was observed a prolonged enhanced immune response to infection in the form of a persistently high level of anti-Spike IgG despite subsequent plasma donations. The presented donor experienced COVID-19 interstitial pneumonia, requiring pharmacotherapy in a hospital setting (therapy involving azithromycin, chloroquine and protease inhibitors), which allowed him to achieve remission. The described donor donated plasma nine times during convalescence, each time showing a satisfactory level of anti-Spike IgG. The presented case highlights the multifactorial regulation of the serological response in the course of SARS-CoV-2 infection, which may include the long-term effect of pharmacotherapy, especially in the field of antiretroviral drugs. While the authors are not yet able to clearly define the importance of antiretroviral therapy in regulating the humoral response in COVID-19 patients, it is supposed it may be important in the subsequent antibody production.

Abstract

Despite intensive research, the physiology of the serological response to SARS-CoV-2 infection and its dynamics during the recovery period remain incompletely understood. Regulation of the immune response seems all the more important as it plays a role in both virus clearance during infection and the potential development of long-term resistance to reinfection. A case of convalescent plasma donor is described in whom was observed a prolonged enhanced immune response to infection in the form of a persistently high level of anti-Spike IgG despite subsequent plasma donations. The presented donor experienced COVID-19 interstitial pneumonia, requiring pharmacotherapy in a hospital setting (therapy involving azithromycin, chloroquine and protease inhibitors), which allowed him to achieve remission. The described donor donated plasma nine times during convalescence, each time showing a satisfactory level of anti-Spike IgG. The presented case highlights the multifactorial regulation of the serological response in the course of SARS-CoV-2 infection, which may include the long-term effect of pharmacotherapy, especially in the field of antiretroviral drugs. While the authors are not yet able to clearly define the importance of antiretroviral therapy in regulating the humoral response in COVID-19 patients, it is supposed it may be important in the subsequent antibody production.

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Keywords

antiretroviral, azithromycin, chloroquine, convalescent plasma, COVID-19, SARS-CoV-2

About this article
Title

Minimally reduced levels of anti-Spike IgG after nine COVID-19 convalescent plasma donations: a case report

Journal

Medical Research Journal

Issue

Vol 6, No 2 (2021)

Article type

Case report

Pages

157-160

Published online

2021-04-16

DOI

10.5603/MRJ.a2021.0017

Bibliographic record

Medical Research Journal 2021;6(2):157-160.

Keywords

antiretroviral
azithromycin
chloroquine
convalescent plasma
COVID-19
SARS-CoV-2

Authors

Tomasz Wasiluk
Kamila Rybinska
Anna Rogowska
Barbara Boczkowska-Radziwon
Piotr Radziwon

References (10)
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  2. Ibarrondo FJ, Fulcher JA, Goodman-Meza D, et al. Rapid Decay of Anti-SARS-CoV-2 Antibodies in Persons with Mild Covid-19. N Engl J Med. 2020; 383(11): 1085–1087.
  3. Vaisman-Mentesh A, Dror Y, Tur-Kaspa R, et al. SARS-CoV-2 specific memory B-cells frequency in recovered patient remains stable while antibodies decay over time. .
  4. Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). Chin Med J (Engl). 2020; 133(9): 1087–1095.
  5. An EU programme of COVID-19 convalescent plasma collection and transfusion. Guidance on collection, testing, processing, storage, distribution and monitored use. https://ec.europa.eu/health/sites/health/files/blood_tissues_organs/docs/guidance_plasma_covid19_en.pdf. (23/06/2020).
  6. Bonelli F, Sarasini A, Zierold C, et al. Clinical and Analytical Performance of an Automated Serological Test That Identifies S1/S2-Neutralizing IgG in COVID-19 Patients Semiquantitatively. J Clin Microbiol. 2020; 58(9).
  7. Coates J. Relationship between Anti-Spike Protein Antibody Titers and SARS-CoV-2 In Vitro Virus Neutralization in Convalescent Plasma. bioRxiv : the preprint server for biology. .
  8. Bleyzac N, Goutelle S, Bourguignon L, et al. Azithromycin for COVID-19: More Than Just an Antimicrobial? Clin Drug Investig. 2020; 40(8): 683–686.
  9. Fernandez AD, Elmore MK, Metzger DW. Azithromycin modulates murine immune responses to pneumococcal conjugate vaccine and inhibits nasal clearance of bacteria. J Infect Dis. 2004; 190(10): 1762–1766.
  10. Moir S, Buckner CM, Ho J, et al. B cells in early and chronic HIV infection: evidence for preservation of immune function associated with early initiation of antiretroviral therapy. Blood. 2010; 116(25): 5571–5579.

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