BackgroundSince the beginning of the COVID-19 pandemic, patients with Inborn Errors of Immunity have been infected by SARS-CoV-2 virus showing a spectrum of disease ranging from asymptomatic to severe COVID-19. A fair number of patients did not respond adequately to SARS-CoV-2 vaccinations, thus early therapeutic or prophylactic measures were needed to prevent severe or fatal course or COVID-19 and to reduce the burden of hospitalizations. MethodsLongitudinal, multicentric study on patients with Inborn Errors of Immunity immunized with mRNA vaccines treated with monoclonal antibodies and/or antiviral agents at the first infection and at reinfection by SARS-CoV-2. Analyses of efficacy were performed according to the different circulating SARS-CoV-2 strains. ResultsThe analysis of the cohort of 192 SARS-CoV-2 infected patients, across 26 months, showed the efficacy of antivirals on the risk of hospitalization, while mabs offered a positive effect on hospitalization, and COVID-19 severity. This protection was consistent across the alpha, delta and early omicron waves, although the emergence of BA.2 reduced the effect of available mabs. Hospitalized patients treated with mabs and antivirals had a lower risk of ICU admission. We reported 16 re-infections with a length of SARS-CoV-2 positivity at second infection shorter among patients treated with mabs. Treatment with antivirals and mabs was safe. ConclusionsThe widespread use of specific therapy, vaccination and better access to care might have contributed to mitigate risk of mortality, hospital admission, and severe disease. However, the rapid spread of new viral strains underlines that mabs and antiviral beneficial effects should be re- evaluated over time.

Real-life data on monoclonal antibodies and antiviral drugs in Italian inborn errors of immunity patients during COVID-19 pandemic / Garzi, Giulia; Cinetto, Francesco; Firinu, Davide; Di Napoli, Giulia; Lagnese, Gianluca; Punziano, Alessandra; Bez, Patrick; Cinicola, Bianca Laura; Costanzo, Giulia; Scarpa, Riccardo; Pulvirenti, Federica; Rattazzi, Marcello; Spadaro, Giuseppe; Quinti, Isabella; Milito, Cinzia. - In: FRONTIERS IN IMMUNOLOGY. - ISSN 1664-3224. - 13:(2022). [10.3389/fimmu.2022.947174]

Real-life data on monoclonal antibodies and antiviral drugs in Italian inborn errors of immunity patients during COVID-19 pandemic

Garzi, Giulia;Cinicola, Bianca Laura;Quinti, Isabella
Penultimo
;
Milito, Cinzia
Ultimo
2022

Abstract

BackgroundSince the beginning of the COVID-19 pandemic, patients with Inborn Errors of Immunity have been infected by SARS-CoV-2 virus showing a spectrum of disease ranging from asymptomatic to severe COVID-19. A fair number of patients did not respond adequately to SARS-CoV-2 vaccinations, thus early therapeutic or prophylactic measures were needed to prevent severe or fatal course or COVID-19 and to reduce the burden of hospitalizations. MethodsLongitudinal, multicentric study on patients with Inborn Errors of Immunity immunized with mRNA vaccines treated with monoclonal antibodies and/or antiviral agents at the first infection and at reinfection by SARS-CoV-2. Analyses of efficacy were performed according to the different circulating SARS-CoV-2 strains. ResultsThe analysis of the cohort of 192 SARS-CoV-2 infected patients, across 26 months, showed the efficacy of antivirals on the risk of hospitalization, while mabs offered a positive effect on hospitalization, and COVID-19 severity. This protection was consistent across the alpha, delta and early omicron waves, although the emergence of BA.2 reduced the effect of available mabs. Hospitalized patients treated with mabs and antivirals had a lower risk of ICU admission. We reported 16 re-infections with a length of SARS-CoV-2 positivity at second infection shorter among patients treated with mabs. Treatment with antivirals and mabs was safe. ConclusionsThe widespread use of specific therapy, vaccination and better access to care might have contributed to mitigate risk of mortality, hospital admission, and severe disease. However, the rapid spread of new viral strains underlines that mabs and antiviral beneficial effects should be re- evaluated over time.
2022
COVID-19; antiviral drugs; disease severity; duration of viral shedding; hospitalization-risk; inborn errors of immunity; monoclonal antibodies; reinfection; Antibodies, Monoclonal; Antiviral Agents; Humans; Pandemics; SARS-CoV-2; Antineoplastic Agents, Immunological; COVID-19
01 Pubblicazione su rivista::01a Articolo in rivista
Real-life data on monoclonal antibodies and antiviral drugs in Italian inborn errors of immunity patients during COVID-19 pandemic / Garzi, Giulia; Cinetto, Francesco; Firinu, Davide; Di Napoli, Giulia; Lagnese, Gianluca; Punziano, Alessandra; Bez, Patrick; Cinicola, Bianca Laura; Costanzo, Giulia; Scarpa, Riccardo; Pulvirenti, Federica; Rattazzi, Marcello; Spadaro, Giuseppe; Quinti, Isabella; Milito, Cinzia. - In: FRONTIERS IN IMMUNOLOGY. - ISSN 1664-3224. - 13:(2022). [10.3389/fimmu.2022.947174]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1655903
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