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Ann Clin Microbiol Antimicrob . 2021 Dec 30

Persistent SARS-CoV-2 infection in patients with secondary antibody deficiency: successful clearance following combination casirivimab and imdevimab (REGN-COV2) monoclonal antibody therapy

Yusri Taha, Hayley Wardle, Adam B Evans, Ewan R Hunter, Helen Marr, Wendy Osborne, Matthew Bashton, Darren Smith, Shirelle Burton-Fanning, Matthias L Schmid, Christopher J A Duncan

Background: There is growing evidence that antibody responses play a role in the resolution of SARS-CoV-2 infection. Patients with primary or secondary antibody deficiency are at increased risk of persistent infection. This challenging clinical scenario is associated with adverse patient outcome and potentially creates an ecological niche for the evolution of novel SARS-CoV-2 variants with immune evasion capacity. Case reports and/or series have implied a therapeutic role for convalescent plasma (CP) to secure virological clearance, although concerns have been raised about the effectiveness of CP and its potential to drive viral evolution, and it has largely been withdrawn from clinical use in the UK.

PMID: 34969393