Abstract
Polyclonal preparation of IgM as an adjuvant therapy has been reported as a relevant immunomodulant therapy in several infectious diseases, exhibiting, in most cases, improvement of the clinical course. No drug has demonstrated therapeutic efficacy for COVID-19. Immunomodulatory treatment with hydroxychloroquine and biologics as tocilizumab, in fact, has not proven to show satisfactory results in several reports. We therefore treated a selected patient with interstitial multifocal pneumonia, positive to COVID-19, with polyclonal preparation of immunoglobulins as an adjuvant therapy, obtaining in few days clinical remission and improvements in radiological findings. Based on this case report, we suggest that clinical trials are conducted to test the efficacy and safety of polyclonal immunoglobulins for adjunctive therapy of COVID-19.
Highlights
After its recent identification in China, COVID-19 may appear with different clinical features [1]; it may be, asymptomatic, and it may induce isolated pneumonia as well as multifocal bilateral interstitial pneumonia, which may lead to severe acute respiratory syndrome (SARS) [2]
We here report our clinical experience in one selected case of COVID-19 with polyclonal preparation of IgM as adjuvant therapy (i.e., PENTAGLOBIN) in addition to antiviral and immunomodulant therapy and to antithrombotic prophylaxis; the case has been interesting because the patient showed a fast clinical and radiological improvement in 10 days
After the administration of PENTAGLOBIN, we checked levels of IgG and IgM anti COVID-19 in the patient again (i.e., 7 days later), and we found that her levels were increased, and they were associated with a serum conversion of immunoglobulins: IgG anti COVID-19 increased to 73.30 UI/ml IgM, and anti COVID19 increased to 0.41 UI\ml (Table 1)
Summary
After its recent identification in China, COVID-19 may appear with different clinical features [1]; it may be, asymptomatic, and it may induce isolated pneumonia as well as multifocal bilateral interstitial pneumonia, which may lead to severe acute respiratory syndrome (SARS) [2]. On the day April 8, 2020, due to worsening of lung performance testified by clinical features and with arterialblood gas analysis (P/F 200 with respiratory rate of 24 acts p.m.), we began therapy with intravenous polyclonal immunoglobulins (i.e., PENTAGLOBIN, Biotest, Germany) We chose this kind of drug because the personal anamnesis of inherited thrombophilia that could be associated to increased rate of venous thromboembolism during prolonged hospitalization and/or during COVID-19 infection. A clinical and laboratory follow-up was planned 15 days after hospital discharge, and a further nasopharyngeal swab (Real-time PCR, DiaSorin Molecular SimplexaTM COVID-19 Direct assay, DiaSorin S.p.A., Italy) tested negative; levels of IgG and IgM anti COVID-19 were tested again, and the previous trend was confirmed by results, as IgG anti COVID-19 was increased to TABLE 1 | Laboratory tests for the studied patient. Verbal informed consent was given by the patient to describe her clinical experience; in this way, we have been awarded with a recognition for “Best practice” from our Health management and from the ethics committee of AO dei Colli
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
