Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report
Authors
Galloway, James B.
Fhogartaigh, Caoimhe Nic
Meredith, Luke
Provine, Nicholas M.
Bloor, Stuart
Zelek, Wioleta M.
Smielewska, Anna
Yakovleva, Anna
Mann, Tiffeney
Bergamaschi, Laura
Turner, Lorinda
Hackstein, Carl-Philipp
Akther, Hossain Delowar
Ceron-Gutierrez, Lourdes
Periselneris, Jimstan
Grigoriadou, Sofia
Vaghela, Devan
Lear, Sara E.
Török, M. Estée
Hamilton, William L.
Stockton, Joanne
Quick, Josh
Nelson, Peter
Hunter, Michael
Coulter, Tanya I.
Devlin, Lisa
Bradley, John R.
Smith, Kenneth G. C.
Estcourt, Lise
Harvala, Heli
Roberts, David J.
Wilkinson, Ian B.
Screaton, Nick
Loman, Nicholas
Doffinger, Rainer
Morgan, B. Paul
Goodfellow, Ian G.
Klenerman, Paul
Publication Date
2020-12-14Journal Title
Nature Communications
Publisher
Nature Publishing Group UK
Volume
11
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Buckland, M. S., Galloway, J. B., Fhogartaigh, C. N., Meredith, L., Provine, N. M., Bloor, S., Ogbe, A., et al. (2020). Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report. Nature Communications, 11 (1) https://doi.org/10.1038/s41467-020-19761-2
Abstract
Abstract: The response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-linked agammaglobulinaemia (XLA). Despite evidence of complement activation and a robust T cell response, the patient developed persistent SARS-CoV-2 pneumonitis, without progressing to multi-organ involvement. This unusual clinical course is consistent with a contribution of antibodies to both viral clearance and progression to severe disease. In the absence of these confounders, we take an experimental medicine approach to examine the in vivo utility of remdesivir. Over two independent courses of treatment, we observe a temporally correlated clinical and virological response, leading to clinical resolution and viral clearance, with no evidence of acquired drug resistance. We therefore provide evidence for the antiviral efficacy of remdesivir in vivo, and its potential benefit in selected patients.
Keywords
Article, /631/326/596/1296, /631/326/596/4130, /692/699/249/2512, /692/699/255/2514, /13/31, /13/1, article
Identifiers
s41467-020-19761-2, 19761
External DOI: https://doi.org/10.1038/s41467-020-19761-2
This record's URL: https://www.repository.cam.ac.uk/handle/1810/315391
Rights
Attribution 4.0 International (CC BY 4.0)
Licence URL: https://creativecommons.org/licenses/by/4.0/
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