Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report
The response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado em: |
Springer Nature
2020
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| _version_ | 1826282880898170880 |
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| author | Buckland, MS Galloway, JB Fhogartaigh, CN Meredith, L Provine, NM Bloor, S Ogbe, A Zelek, WM Smielewska, A Yakovleva, A Mann, T Bergamaschi, L Turner, L Mescia, F Toonen, EJM Hackstein, C-P Akther, HD Vieira, VA Ceron-Gutierrez, L Periselneris, J Kiani-Alikhan, S Grigoriadou, S Vaghela, D Lear, SE Török, ME Hamilton, WL Stockton, J Quick, J Nelson, P Hunter, M Coulter, TI Devlin, L CITIID-NIHR COVID-19 BioResource Collaboration MRC-Toxicology Unit COVID-19 Consortium Bradley, JR Smith, KGC Ouwehand, WH Estcourt, L Harvala, H Roberts, DJ Wilkinson, IB Screaton, N Loman, N Doffinger, R Lyons, PA Morgan, BP Goodfellow, IG Klenerman, P Lehner, PJ Matheson, NJ |
| author_facet | Buckland, MS Galloway, JB Fhogartaigh, CN Meredith, L Provine, NM Bloor, S Ogbe, A Zelek, WM Smielewska, A Yakovleva, A Mann, T Bergamaschi, L Turner, L Mescia, F Toonen, EJM Hackstein, C-P Akther, HD Vieira, VA Ceron-Gutierrez, L Periselneris, J Kiani-Alikhan, S Grigoriadou, S Vaghela, D Lear, SE Török, ME Hamilton, WL Stockton, J Quick, J Nelson, P Hunter, M Coulter, TI Devlin, L CITIID-NIHR COVID-19 BioResource Collaboration MRC-Toxicology Unit COVID-19 Consortium Bradley, JR Smith, KGC Ouwehand, WH Estcourt, L Harvala, H Roberts, DJ Wilkinson, IB Screaton, N Loman, N Doffinger, R Lyons, PA Morgan, BP Goodfellow, IG Klenerman, P Lehner, PJ Matheson, NJ |
| author_sort | Buckland, MS |
| collection | OXFORD |
| description | The response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-linked agammaglobulinaemia (XLA). Despite evidence of complement activation and a robust T cell response, the patient developed persistent SARS-CoV-2 pneumonitis, without progressing to multi-organ involvement. This unusual clinical course is consistent with a contribution of antibodies to both viral clearance and progression to severe disease. In the absence of these confounders, we take an experimental medicine approach to examine the in vivo utility of remdesivir. Over two independent courses of treatment, we observe a temporally correlated clinical and virological response, leading to clinical resolution and viral clearance, with no evidence of acquired drug resistance. We therefore provide evidence for the antiviral efficacy of remdesivir in vivo, and its potential benefit in selected patients. |
| first_indexed | 2024-03-07T00:50:31Z |
| format | Journal article |
| id | oxford-uuid:863e4b74-c5bc-4e13-9fb0-c1eb02bf8b4e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:50:31Z |
| publishDate | 2020 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:863e4b74-c5bc-4e13-9fb0-c1eb02bf8b4e2022-03-26T22:02:48ZTreatment of COVID-19 with remdesivir in the absence of humoral immunity: a case reportJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:863e4b74-c5bc-4e13-9fb0-c1eb02bf8b4eEnglishSymplectic ElementsSpringer Nature2020Buckland, MSGalloway, JBFhogartaigh, CNMeredith, LProvine, NMBloor, SOgbe, AZelek, WMSmielewska, AYakovleva, AMann, TBergamaschi, LTurner, LMescia, FToonen, EJMHackstein, C-PAkther, HDVieira, VACeron-Gutierrez, LPeriselneris, JKiani-Alikhan, SGrigoriadou, SVaghela, DLear, SETörök, MEHamilton, WLStockton, JQuick, JNelson, PHunter, MCoulter, TIDevlin, LCITIID-NIHR COVID-19 BioResource CollaborationMRC-Toxicology Unit COVID-19 ConsortiumBradley, JRSmith, KGCOuwehand, WHEstcourt, LHarvala, HRoberts, DJWilkinson, IBScreaton, NLoman, NDoffinger, RLyons, PAMorgan, BPGoodfellow, IGKlenerman, PLehner, PJMatheson, NJThe response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-linked agammaglobulinaemia (XLA). Despite evidence of complement activation and a robust T cell response, the patient developed persistent SARS-CoV-2 pneumonitis, without progressing to multi-organ involvement. This unusual clinical course is consistent with a contribution of antibodies to both viral clearance and progression to severe disease. In the absence of these confounders, we take an experimental medicine approach to examine the in vivo utility of remdesivir. Over two independent courses of treatment, we observe a temporally correlated clinical and virological response, leading to clinical resolution and viral clearance, with no evidence of acquired drug resistance. We therefore provide evidence for the antiviral efficacy of remdesivir in vivo, and its potential benefit in selected patients. |
| spellingShingle | Buckland, MS Galloway, JB Fhogartaigh, CN Meredith, L Provine, NM Bloor, S Ogbe, A Zelek, WM Smielewska, A Yakovleva, A Mann, T Bergamaschi, L Turner, L Mescia, F Toonen, EJM Hackstein, C-P Akther, HD Vieira, VA Ceron-Gutierrez, L Periselneris, J Kiani-Alikhan, S Grigoriadou, S Vaghela, D Lear, SE Török, ME Hamilton, WL Stockton, J Quick, J Nelson, P Hunter, M Coulter, TI Devlin, L CITIID-NIHR COVID-19 BioResource Collaboration MRC-Toxicology Unit COVID-19 Consortium Bradley, JR Smith, KGC Ouwehand, WH Estcourt, L Harvala, H Roberts, DJ Wilkinson, IB Screaton, N Loman, N Doffinger, R Lyons, PA Morgan, BP Goodfellow, IG Klenerman, P Lehner, PJ Matheson, NJ Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title | Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title_full | Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title_fullStr | Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title_full_unstemmed | Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title_short | Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report |
| title_sort | treatment of covid 19 with remdesivir in the absence of humoral immunity a case report |
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