未经批准:严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染导致2019年冠状病毒病(COVID-19),可以从轻度疾病到以需要机械通气的急性呼吸窘迫为特征的严重表型。患有联合免疫缺陷的儿童可能无法对COVID-19产生足够的细胞和体液免疫反应,并患有持续性疾病。
UNASSIGNED:我们的目的是描述在持续SARS-CoV-2感染的情况下,单倍体HSCT后合并免疫缺陷和有利的造血干细胞移植(HSCT)过程的儿童。
未经证实:一名患有II类MHC缺乏症的13个月大女孩出现了持续的HSCT前SARS-CoV-2感染。面对平衡由于免疫系统功能不全而导致的进行性感染风险与HSCT后炎症性肺炎周围免疫重建的危险的重大挑战,患者的医生进行了母亲(最近有COVID-19感染史)单倍体HSCT。患者接受regdanvimab(干细胞输注后)和remdesivivir(干细胞输注前后)。
未经评估:患者的周期阈值逐渐增加,意味着病毒RNA的减少,伴随着CD3淋巴细胞亚群的扩增以及临床和放射学的改善。
UNASSIGNED:单倍体HSCT后,母体CD45RO记忆回补T淋巴细胞的过继转移以及使用regdanvimab(SARS-CoV-2-中和mAb)和remesivivir的组合可能导致了我们的患者成功的结果患有HSCT后患有严重免疫缺陷。这个案例突出了新型抗病毒策略(mAb和CD45RO+记忆T淋巴细胞)在具有挑战性的临床场景中有助于病毒清除的作用。
UNASSIGNED: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to coronavirus disease 2019 (COVID-19), which can range from a mild illness to a severe phenotype characterized by acute respiratory distress needing mechanical ventilation. Children with combined immunodeficiencies might be unable to mount a sufficient cellular and humoral immune response against COVID-19 and have persistent disease.
UNASSIGNED: Our aim was to describe a child with combined immunodeficiency and a favorable post-hematopoietic stem cell transplant (HSCT) course following a haploidentical HSCT in the presence of persistent SARS-CoV-2 infection.
UNASSIGNED: A 13-month-old girl with MHC class II deficiency developed persistent pre-HSCT SARS-CoV-2 infection. Faced with a significant challenge of balancing the risk of progressive infection due to an incompetent immune system with the danger of inflammatory pneumonitis peri-immune reconstitution after HSCT, the patient\'s physicians performed a maternal (with a recent history of COVID-19 infection) haploidentical HSCT. The patient received regdanvimab (after stem cell infusion) and remdesivir (before and after stem cell infusion).
UNASSIGNED: The patient exhibited a gradual increase in her cycle threshold values, implying a reduction in viral RNA with concomitant expansion in the CD3 lymphocyte subset and clinical and radiologic improvement.
UNASSIGNED: Combination of adoptive transfer of maternal CD45RO+ memory addback T lymphocytes after haploidentical HSCT and use of regdanvimab (a SARS-CoV-2-neutralizing mAb) and remdesivir may have led to the successful outcome in our patient with severe immunodeficiency after she had undergone HSCT. This case highlights the role of novel antiviral strategies (mAbs and CD45RO+ memory T lymphocytes) in contributing to viral clearance in a challenging clinical scenario.