Struggling with COVID-19 in Adult Inborn Errors of Immunity Patients: A Case Series of Combination Therapy and Multiple Lines of Therapy for Selected Patients
Patrick Bez,
Giancarlo D’ippolito,
Carla Maria Deiana,
Renato Finco Gambier,
Andrea Pica,
Giulia Costanzo,
Giulia Garzi,
Riccardo Scarpa,
Nicholas Landini,
Francesco Cinetto,
Davide Firinu,
Cinzia Milito
Affiliations
Patrick Bez
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana, 31100 Treviso, Italy
Giancarlo D’ippolito
Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
Carla Maria Deiana
Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
Renato Finco Gambier
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana, 31100 Treviso, Italy
Andrea Pica
Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
Giulia Costanzo
Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
Giulia Garzi
Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
Riccardo Scarpa
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana, 31100 Treviso, Italy
Nicholas Landini
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy
Francesco Cinetto
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana, 31100 Treviso, Italy
Davide Firinu
Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
Cinzia Milito
Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
Background: The SARS-CoV-2 infection is now a part of the everyday lives of immunocompromised patients, but the choice of treatment and the time of viral clearance can often be complex, exposing patients to possible complications. The role of the available antiviral and monoclonal therapies is a matter of debate, as are their effectiveness and potential related adverse effects. To date, in the literature, the amount of data on the use of combination therapies and on the multiple lines of anti-SARS-CoV-2 therapy available to the general population and especially to inborn error of immunity (IEI) patients is small. Methods: Here, we report a case series of five adult IEI patients managed as inpatients at three Italian IEI referral centers (Rome, Treviso, and Cagliari) treated with combination therapy or multiple therapeutic lines for SARS-CoV-2 infection, such as monoclonal antibodies (mAbs), antivirals, convalescent plasma (CP), mAbs plus antiviral, and CP combined with antiviral. Results: This study may support the use of combination therapy against SARS-CoV-2 in complicated IEI patients with predominant antibody deficiency and impaired vaccine response.
