Anti-complement C5 therapy with eculizumab in three cases of critical COVID-19.
Acute Kidney Injury
/ complications
Adult
Antibodies, Monoclonal, Humanized
/ therapeutic use
Betacoronavirus
/ immunology
Biomarkers
/ metabolism
COVID-19
Complement Activation
/ drug effects
Complement C4b
/ antagonists & inhibitors
Complement C5
/ antagonists & inhibitors
Complement Inactivating Agents
/ therapeutic use
Complement Membrane Attack Complex
/ antagonists & inhibitors
Coronavirus Infections
/ complications
Cytokine Release Syndrome
/ complications
Female
Fibrin Fibrinogen Degradation Products
/ metabolism
Humans
Immunity, Humoral
/ drug effects
Male
Mannose-Binding Protein-Associated Serine Proteases
/ genetics
Middle Aged
Neutrophils
/ immunology
Pandemics
Peptide Fragments
/ antagonists & inhibitors
Pneumonia, Viral
/ complications
SARS-CoV-2
Severe Acute Respiratory Syndrome
/ complications
COVID-19
Complement
Coronavirus
Eculizumab
Lectin pathway
MASP2
Journal
Clinical immunology (Orlando, Fla.)
ISSN: 1521-7035
Titre abrégé: Clin Immunol
Pays: United States
ID NLM: 100883537
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
15
07
2020
revised:
29
07
2020
accepted:
03
08
2020
pubmed:
11
8
2020
medline:
15
9
2020
entrez:
11
8
2020
Statut:
ppublish
Résumé
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 FiO
Identifiants
pubmed: 32771488
pii: S1521-6616(20)30665-3
doi: 10.1016/j.clim.2020.108555
pmc: PMC7410014
pii:
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Biomarkers
0
Complement C5
0
Complement Inactivating Agents
0
Complement Membrane Attack Complex
0
Fibrin Fibrinogen Degradation Products
0
Peptide Fragments
0
fibrin fragment D
0
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
EC 3.4.21.-
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
108555Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Références
Clin Immunol. 2020 Jun;215:108450
pubmed: 32360516
Eur Rev Med Pharmacol Sci. 2020 Apr;24(7):4040-4047
pubmed: 32329881
Blood. 2018 Sep 27;132(13):1426-1437
pubmed: 30068506
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Lancet. 2020 May 16;395(10236):1569-1578
pubmed: 32423584
Clin Exp Immunol. 2021 Jan;203(1):96-104
pubmed: 32681658
J Exp Med. 1999 Feb 1;189(3):599-604
pubmed: 9927522
Circulation. 2020 Jun 2;141(22):1739-1741
pubmed: 32271624
N Engl J Med. 2020 May 21;382(21):2012-2022
pubmed: 32227758
BMJ. 2020 May 22;369:m1985
pubmed: 32444460
J Allergy Clin Immunol. 2020 Jul;146(1):215-217
pubmed: 32417135
Emerg Microbes Infect. 2018 Apr 24;7(1):77
pubmed: 29691378
Clin Adv Hematol Oncol. 2020 Apr;18(4):221-230
pubmed: 32628650
Open Rheumatol J. 2017 Sep 30;11:113-122
pubmed: 29290848
Nat Rev Immunol. 2020 Jun;20(6):343-344
pubmed: 32327719
mBio. 2018 Oct 9;9(5):
pubmed: 30301856
Kidney Int. 2020 May;97(5):829-838
pubmed: 32247631
Blood. 2020 Jun 4;135(23):2033-2040
pubmed: 32339221
Front Immunol. 2018 Sep 12;9:2035
pubmed: 30258440
Am J Hematol. 2020 Jun;95(6):E131-E134
pubmed: 32129508
Clin Immunol. 2020 Jun;215:108448
pubmed: 32353634
Front Pharmacol. 2020 Jun 05;11:857
pubmed: 32581810
Lancet Infect Dis. 2020 May;20(5):565-574
pubmed: 32213337
Transl Res. 2020 Jun;220:1-13
pubmed: 32299776
JAMA Neurol. 2020 Jun 1;77(6):683-690
pubmed: 32275288
Arterioscler Thromb Vasc Biol. 2018 Apr;38(4):709-725
pubmed: 29437578