Clearance of Persistent SARS-CoV-2 RNA Detection in a NFκB-Deficient Patient in Association with the Ingestion of Human Breast Milk: A Case Report
Janine S. Sabino,
Mariene R. Amorim,
William M. de Souza,
Lia F. Marega,
Luciana S. Mofatto,
Daniel A. Toledo-Teixeira,
Julia Forato,
Rodrigo G. Stabeli,
Maria Laura Costa,
Fernando R. Spilki,
Ester C. Sabino,
Nuno R. Faria,
Bruno D. Benites,
Marcelo Addas-Carvalho,
Raquel S. B. Stucchi,
Dewton M. Vasconcelos,
Scott C. Weaver,
Fabiana Granja,
José Luiz Proenca-Modena,
Maria Marluce dos S. Vilela
Affiliations
Janine S. Sabino
Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
Mariene R. Amorim
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
William M. de Souza
World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
Lia F. Marega
Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
Luciana S. Mofatto
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
Daniel A. Toledo-Teixeira
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
Julia Forato
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
Rodrigo G. Stabeli
Oswaldo Cruz Foundation (Fiocruz-SP), Ribeirão Preto 14049-900, Brazil
Maria Laura Costa
Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
Fernando R. Spilki
One Health Laboratory, Feevale University, Novo Hamburgo 93510-235, Brazil
Ester C. Sabino
Tropical Medicine Institute, Medical School, University of São Paulo, São Paulo 5403-907, Brazil
Nuno R. Faria
Department of Infectious and Parasitic Disease, Medical School, University of São Paulo, São Paulo 05403-000, Brazil
Bruno D. Benites
Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil
Marcelo Addas-Carvalho
Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil
Raquel S. B. Stucchi
Division of Infectious Diseases, University of Campinas, Campinas 13083-887, Brazil
Dewton M. Vasconcelos
Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo, São Paulo 05403-000, Brazil
Scott C. Weaver
World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
Fabiana Granja
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
José Luiz Proenca-Modena
Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil
Maria Marluce dos S. Vilela
Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
Currently, there are no evidence-based treatment options for long COVID-19, and it is known that SARS-CoV-2 can persist in part of the infected patients, especially those with immunosuppression. Since there is a robust secretion of SARS-CoV-2-specific highly-neutralizing IgA antibodies in breast milk, and because this immunoglobulin plays an essential role against respiratory virus infection in mucosa cells, being, in addition, more potent in neutralizing SARS-CoV-2 than IgG, here we report the clinical course of an NFκB-deficient patient chronically infected with the SARS-CoV-2 Gamma variant, who, after a non-full effective treatment with plasma infusion, received breast milk from a vaccinated mother by oral route as treatment for COVID-19. After such treatment, the symptoms improved, and the patient was systematically tested negative for SARS-CoV-2. Thus, we hypothesize that IgA and IgG secreted antibodies present in breast milk could be useful to treat persistent SARS-CoV-2 infection in immunodeficient patients.
