Anti-complement C5 therapy with eculizumab in three cases of critical COVID-19

Anti-complement C5 therapy with eculizumab in three cases of critical COVID-19

Copyright © 2020 Elsevier Inc. All rights reserved.

Bibliographische Detailangaben
Veröffentlicht in:Clinical immunology (Orlando, Fla.). - 1999. - 219(2020) vom: 10. Okt., Seite 108555
1. Verfasser: Laurence, Jeffrey (VerfasserIn)
Weitere Verfasser: Mulvey, J Justin, Seshadri, Madhav, Racanelli, Alexandra, Harp, Joanna, Schenck, Edward J, Zappetti, Dana, Horn, Evelyn M, Magro, Cynthia M
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2020
Zugriff auf das übergeordnete Werk:Clinical immunology (Orlando, Fla.)
Schlagworte:Case Reports Journal Article Research Support, Non-U.S. Gov't COVID-19 Complement Coronavirus Eculizumab Lectin pathway MASP2 Antibodies, Monoclonal, Humanized mehr... Biomarkers Complement C5 Complement Inactivating Agents Complement Membrane Attack Complex Fibrin Fibrinogen Degradation Products Peptide Fragments fibrin fragment D Complement C4b 80295-50-7 complement C4d 80295-52-9 eculizumab A3ULP0F556 MASP2 protein, human EC 3.4.21.- Mannose-Binding Protein-Associated Serine Proteases
Beschreibung
Zusammenfassung:Copyright © 2020 Elsevier Inc. All rights reserved.
Respiratory failure and acute kidney injury (AKI) are associated with high mortality in SARS-CoV-2-associated Coronavirus disease 2019 (COVID-19). These manifestations are linked to a hypercoaguable, pro-inflammatory state with persistent, systemic complement activation. Three critical COVID-19 patients recalcitrant to multiple interventions had skin biopsies documenting deposition of the terminal complement component C5b-9, the lectin complement pathway enzyme MASP2, and C4d in microvascular endothelium. Administration of anti-C5 monoclonal antibody eculizumab led to a marked decline in D-dimers and neutrophil counts in all three cases, and normalization of liver functions and creatinine in two. One patient with severe heart failure and AKI had a complete remission. The other two individuals had partial remissions, one with resolution of his AKI but ultimately succumbing to respiratory failure, and another with a significant decline in FiO2 requirements, but persistent renal failure. In conclusion, anti-complement therapy may be beneficial in at least some patients with critical COVID-19
Beschreibung:Date Completed 14.09.2020
Date Revised 29.03.2024
published: Print-Electronic
Citation Status MEDLINE
ISSN:1521-7035
DOI:10.1016/j.clim.2020.108555