PMC8097002_01
Clinical, biological and radiological follow-up before and after plasma transfusions. (A-E), Timeline of chronic SARS-COV-2 infection in a severely immunosuppressed patient showing inflammatory markers (A), chest CT scan (B), clinical parameters (C), MoCA (Montreal Cognitive Assessment) scores (D), and complete blood counts (E). (B), Axial slices focused at the level of the apical segment of the right lower lobe. Progressive worsening from multiple ill-defined areas of ground glass opacities progressing to patchy alveolar consolidation of increasing size. Note the subpleural (blue arrows) and peribronchial (orange arrows) distribution of the lesions with progressive improvement on post-therapeutic follow-up, alveolar consolidation being replaced by ground glass opacity. (A-E), Arrows indicate the 4 cycles of plasma transfusion (two units given on two consecutive days of each cycle). The "*" show the three injections of granulocyte-colony stimulating factor (filgrastim), while "T" indicates the two red blood cell transfusions. Of note, filgrastim injections (< day 40) and red blood cell transfusions did not result in symptom improvements.
fimmu-12-613502-g001.jpg
PMC8097002_01_fimmu-12-613502-g001.jpg
f1
Laboratory analyses showed a moderate neutropenia, but severe T (114 cell/mm3) and B (1 cell/mm3) lymphopenia with reduced total immunoglobulin (Ig) G and IgM levels (Supplementary Figure 1A), while inflammatory markers (C-reactive protein and ferritin) were elevated (Figure 1A). Chest computed tomography (CT) revealed bilateral multifocal subpleural and peribronchial ground-glass opacities typical of COVID-19 pneumonia (Figure 1B and Supplementary Figure 2). Information). Inflammatory parameters and blood cell counts remained abnormal (Figures 1A, E), while persisting SARS-CoV-2 infection was confirmed (Supplementary Figure 1B).
Anti-SARS-CoV-2 antibody and SARS-CoV-2 mRNA follow-up before and after plasma transfusions. (A, B), Timeline showing absolute CD4 and CD8 T cell counts, including effector-memory subsets and NK cell counts (A), and absolute B cell counts (B). (C, D), Anti-SARS-CoV-2 S protein IgG, IgA and IgM antibody levels as assessed by an in-house developed Luminex assay for each plasma (C) as well as in the patient's serum before and following plasma transfusions (D). (E), Activity of neutralizing antibodies was assessed by a SARS-CoV-2 pseudovirus neutralization assay for each plasma and in patient's serum at different time-points. (F), Over-time follow-up of SARS-CoV-2 RNA detection in nasopharyngeal swabs. The cytopathic effect on VeroE6 cells was evaluated after inoculation with SARS-CoV-2 from nasopharyngeal swabs: C+, successful virus isolation; C-, absence of virus isolation. (A-F), The arrows indicate the 4 cycles of plasma transfusion (two units given on two consecutive days of each cycle).
fimmu-12-613502-g002.jpg
PMC8097002_01_fimmu-12-613502-g002.jpg
f2
Chest computed tomography (CT) revealed bilateral multifocal subpleural and peribronchial ground-glass opacities typical of COVID-19 pneumonia (Figure 1B and Supplementary Figure 2).