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Venturini E, Fusani L, Lo Vecchio A, Scarano SM, Garazzino S, Pruccoli G, Donà D, Lancella L, Castelli Gattinara G, Galli L. Safety of Sotrovimab use in children with COVID-19: an Italian experience. J Chemother 2024; 36:45-48. [PMID: 37605372 DOI: 10.1080/1120009x.2023.2250138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
Sotrovimab is a monoclonal antibody approved in adult and adolescents at high risk for COVID-19. Thirty-three children evaluated in five Italian paediatric centres received Sotrovimab infusion and were retrospectively enrolled from December 2021 to April 2022. In more than half of cases (19/33, 57.6%) Sotrovimab was prescribed off-label. Overall, the infusion was well tolerated with no significative differences in those receiving an off-label prescription. All children had a complete recovery. Data on the safety of Sotrovimab should be investigated in a larger paediatric cohort, considering the continuous selection of new SARS CoV-2 variants which may be more or less susceptible to the effects of the Sotrovimab.
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Affiliation(s)
- Elisabetta Venturini
- Infectious Disease Unit, IRCSS-Meyer Children's University Hospital, Florence, Italy
| | - Lara Fusani
- Infectious Disease Unit, IRCSS-Meyer Children's University Hospital, Florence, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Pediatric Infectious Disease Unit, University of Naples Federico II, Naples, Italy
| | - Sara Maria Scarano
- Department of Translational Medical Sciences, Pediatric Infectious Disease Unit, University of Naples Federico II, Naples, Italy
| | - Silvia Garazzino
- Department of Pediatric and Public Health Sciences, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Giulia Pruccoli
- Department of Pediatric and Public Health Sciences, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Daniele Donà
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Padua, Italy
| | | | | | - Luisa Galli
- Infectious Disease Unit, IRCSS-Meyer Children's University Hospital, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
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2
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Bozzola E, Caffarelli C, Santamaria F, Corsello G. Year 2022: exploring COVID-19 pandemic in children. Ital J Pediatr 2023; 49:128. [PMID: 37770981 PMCID: PMC10540415 DOI: 10.1186/s13052-023-01536-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
COVID-19 pandemics is rapidly changing. In this article, we review progresses published in the Italian Journal of Pediatrics in 2022. More data on clinical pictures, prevention strategies and active management in children have been provided. The continued evolution of knowledge has driven transformations in the clinical approach to the disease and allowed key advancements in the care of children with COVID-19.
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Affiliation(s)
- Elena Bozzola
- Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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3
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Esposito S, Amirthalingam G, Bassetti M, Blasi F, De Rosa FG, Halasa NB, Hung I, Osterhaus A, Tan T, Torres JP, Vena A, Principi N. Monoclonal antibodies for prophylaxis and therapy of respiratory syncytial virus, SARS-CoV-2, human immunodeficiency virus, rabies and bacterial infections: an update from the World Association of Infectious Diseases and Immunological Disorders and the Italian Society of Antinfective Therapy. Front Immunol 2023; 14:1162342. [PMID: 37256125 PMCID: PMC10226646 DOI: 10.3389/fimmu.2023.1162342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/26/2023] [Indexed: 06/01/2023] Open
Abstract
Monoclonal antibodies (mABs) are safe and effective proteins produced in laboratory that may be used to target a single epitope of a highly conserved protein of a virus or a bacterial pathogen. For this purpose, the epitope is selected among those that play the major role as targets for prevention of infection or tissue damage. In this paper, characteristics of the most important mABs that have been licensed and used or are in advanced stages of development for use in prophylaxis and therapy of infectious diseases are discussed. We showed that a great number of mABs effective against virus or bacterial infections have been developed, although only in a small number of cases these are licensed for use in clinical practice and have reached the market. Although some examples of therapeutic efficacy have been shown, not unlike more traditional antiviral or antibacterial treatments, their efficacy is significantly greater in prophylaxis or early post-exposure treatment. Although in many cases the use of vaccines is more effective and cost-effective than that of mABs, for many infectious diseases no vaccines have yet been developed and licensed. Furthermore, in emergency situations, like in epidemics or pandemics, the availability of mABs can be an attractive adjunct to our armament to reduce the impact. Finally, the availability of mABs against bacteria can be an important alternative, when multidrug-resistant strains are involved.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gayatri Amirthalingam
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Matteo Bassetti
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Respiratory Unit and Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | | | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ivan Hung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Albert Osterhaus
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Tina Tan
- Division of Infectious Diseases, Feinberg School of Medicine of Northwestern University, Chicago, IL, United States
| | - Juan Pablo Torres
- Department of Pediatrics and Pediatric Surgery, Facultad de Medicina, University of Chile, Santiago, Chile
- Instituto Sistemas Complejos de Ingeniería (ISCI), Santiago, Chile
| | - Antonio Vena
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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4
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Manciulli T, Spinicci M, Rossetti B, Antonello RM, Lagi F, Barbiero A, Chechi F, Formica G, Francalanci E, Alesi M, Gaggioli S, Modi G, Modica S, Paggi R, Costa C, Morea A, Paglicci L, Rancan I, Amadori F, Tamborrino A, Tilli M, Bandini G, Pignone AM, Valoriani B, Montagnani F, Tumbarello M, Blanc P, Di Pietro M, Galli L, Aquilini D, Vincenti A, Sani S, Nencioni C, Luchi S, Tacconi D, Zammarchi L, Bartoloni A. Safety and Efficacy of Outpatient Treatments for COVID-19: Real-Life Data from a Regionwide Cohort of High-Risk Patients in Tuscany, Italy (the FEDERATE Cohort). Viruses 2023; 15:v15020438. [PMID: 36851654 PMCID: PMC9967010 DOI: 10.3390/v15020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/28/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023] Open
Abstract
Early COVID-19 treatments can prevent progression to severe disease. However, real-life data are still limited, and studies are warranted to monitor the efficacy and tolerability of these drugs. We retrospectively enrolled outpatients receiving early treatment for COVID-19 in 11 infectious diseases units in the Tuscany region of Italy between 1 January and 31 March 2022, when Omicron sublineages BA.1 and BA.2 were circulating. Eligible COVID-19 patients were treated with sotrovimab (SOT), remdesivir (RMD), nirmatrelvir/ritonavir (NRM/r), or molnupiravir (MOL). We gathered demographic and clinical features, 28-day outcomes (hospitalization or death), and drugs tolerability. A total of 781 patients (median age 69.9, 66% boosted for SARS-CoV-2) met the inclusion criteria, of whom 314 were treated with SOT (40.2%), 205 with MOL (26.3%), 142 with RMD (18.2%), and 120 with NRM/r (15.4%). Overall, 28-day hospitalization and death occurred in 18/781 (2.3%) and 3/781 (0.3%), respectively. Multivariable Cox regression showed that patients receiving SOT had a reduced risk of meeting the composite outcome (28-day hospitalization and/or death) in comparison to the RMD cohort, while no significant differences were evidenced for the MOL and NRM/r groups in comparison to the RMD group. Other predictors of negative outcomes included cancer, chronic kidney disease, and a time between symptoms onset and treatment administration > 3 days. All treatments showed good safety and tolerability, with only eight patients (1%) whose treatment was interrupted due to intolerance. In the first Italian multicenter study presenting real-life data on COVID-19 early treatments, all regimens demonstrated good safety and efficacy. SOT showed a reduced risk of progression versus RMD. No significant differences of outcome were observed in preventing 28-day hospitalization and death among patients treated with RMD, MOL, and NRM/r.
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Affiliation(s)
- Tommaso Manciulli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Michele Spinicci
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
| | - Barbara Rossetti
- UOC Malattie Infettive, Ospedale Misericordia, 58100 Grosseto, Italy
| | - Roberta Maria Antonello
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Filippo Lagi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
| | - Anna Barbiero
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Flavia Chechi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOC Malattie Infettive, Ospedale San Jacopo, 51100 Pistoia, Italy
| | - Giuseppe Formica
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Emanuela Francalanci
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- UO Malattie Infettive, Ospedale Santo Stefano, 59100 Prato, Italy
| | - Mirco Alesi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- UO Malattie Infettive, Ospedale Santo Stefano, 59100 Prato, Italy
| | - Samuele Gaggioli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Giulia Modi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- UO Malattie Infettive, Ospedale Santa Maria Annunziata, 50012 Firenze, Italy
| | - Sara Modica
- SOC Malattie Infettive ed Epatologia, Ospedale San Luca, 55100 Lucca, Italy
| | - Riccardo Paggi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOC Malattie Infettive, Ospedale San Jacopo, 51100 Pistoia, Italy
| | - Cecilia Costa
- UO Malattie Infettive, Ospedale Santa Maria Annunziata, 50012 Firenze, Italy
| | - Alessandra Morea
- UO Malattie Infettive, Ospedali Riuniti di Livorno, 57124 Livorno, Italy
| | | | - Ilaria Rancan
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, 53100 Siena, Italy
| | | | - Agnese Tamborrino
- Dipartimento Scienze della Salute, Università degli Studi di Firenze, 50139 Firenze, Italy
| | - Marta Tilli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- UO Malattie Infettive, Ospedale Santa Maria Annunziata, 50012 Firenze, Italy
| | - Giulia Bandini
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | - Alberto Moggi Pignone
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
| | | | - Francesca Montagnani
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, 53100 Siena, Italy
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero Universitaria Senese, 53100 Siena, Italy
| | - Mario Tumbarello
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, 53100 Siena, Italy
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero Universitaria Senese, 53100 Siena, Italy
| | - Pierluigi Blanc
- SOC Malattie Infettive, Ospedale San Jacopo, 51100 Pistoia, Italy
| | - Massimo Di Pietro
- UO Malattie Infettive, Ospedale Santa Maria Annunziata, 50012 Firenze, Italy
| | - Luisa Galli
- Dipartimento Scienze della Salute, Università degli Studi di Firenze, 50139 Firenze, Italy
- UO Malattie Infettive, Azienda Ospedaliero-Universitaria “Meyer”, 50139 Firenze, Italy
| | | | | | - Spartaco Sani
- UO Malattie Infettive, Ospedali Riuniti di Livorno, 57124 Livorno, Italy
| | - Cesira Nencioni
- UOC Malattie Infettive, Ospedale Misericordia, 58100 Grosseto, Italy
| | - Sauro Luchi
- SOC Malattie Infettive ed Epatologia, Ospedale San Luca, 55100 Lucca, Italy
| | - Danilo Tacconi
- UO Malattie Infettive, Ospedale San Donato, 52100 Arezzo, Italy
| | - Lorenzo Zammarchi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
| | - Alessandro Bartoloni
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Firenze, Italy
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
- Correspondence:
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Abstract
BACKGROUND Although severe COVID-19 in children is rare, those with certain pre-existing health conditions are more prone to severe disease. Monoclonal antibodies (mAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are potent antiviral agents that reduce adverse clinical outcomes in adults, but are commonly not approved for use in pediatric patients. METHODS We retrospectively evaluated mAb treatment in children <12 years of age or <40kg with SARS-CoV-2 infection between January 1, 2021, and March 7, 2022, in 12 tertiary care centers in 3 European countries. RESULTS We received data from 53 patients from Austria, Denmark and Germany. Median age was 5.4 years [0-13.8, interquartile range (IQR) = 6.2], and median body weight was 20 kg (3-50.1, IQR = 13). The most frequent SARS-CoV-2 variant in this study, if known, was Omicron, followed by Delta and Alpha. Pre-existing conditions included immunodeficiency, malignancy, hematologic disease, cardiac disease, chronic lung disease, chronic liver disease, kidney disease and diabetes. Forty-two patients received sotrovimab (79%), 9 casirivimab/imdevimab (17%) and 2 bamlanivimab (4%). All but 1 patient survived. Median duration of hospital stay was 3 days (0-56, IQR = 6). Seven patients required treatment in an intensive care unit, and 5 required high-flow nasal cannula treatment. Potential side effects included neutropenia (6/53, 11%), lymphopenia (3/53, 6%), nausea or vomiting (2/53, 4%), rise of alanine transaminase (1/53, 2%) and hypotonia (1/53, 2%). CONCLUSIONS MAb treatment was well tolerated by children in this cohort.
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Pruccoli G. A Single-center Experience in Treating Young Children at High Risk For Severe COVID-19 With Sotrovimab. Pediatr Infect Dis J 2022; 41:e341-e342. [PMID: 35421051 PMCID: PMC9281427 DOI: 10.1097/inf.0000000000003552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Giulia Pruccoli
- Department of Pediatric and Public Health Sciences, Regina Margherita Childrens Hospital, University of Turin Turin, Italy; Department of Pediatric and Public Health Sciences, Infectious Diseases Unit, Regina Margherita Childrens Hospital, Turin, Italy
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Di Chiara C, Mengato D, De Pieri M, Longo G, Benetti E, Venturini F, Giaquinto C, Donà D. Early Use of Sotrovimab in Children: A Case Report of an 11-Year-Old Kidney Transplant Recipient Infected with SARS-CoV-2. CHILDREN (BASEL, SWITZERLAND) 2022; 9:451. [PMID: 35455495 PMCID: PMC9028505 DOI: 10.3390/children9040451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/19/2022] [Accepted: 03/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The use of virus-neutralizing monoclonal antibodies has been approved in fragile populations, including kidney transplant recipients, who are at risk of developing severe COVID-19. Sotrovimab is the only currently available anti-SARS-CoV-2 neutralizing monoclonal antibody with activity against the new Omicron variant of concern. While sotrovimab has been approved in adolescents and adults, studies regarding its efficacy and safety in children aged less than 12 years old and weighing less than 40 kg are still lacking. Here, we report a first case of a child, who was treated early with sotrovimab after a kidney transplant. CASE REPORT At the end of January 2022, a 11-year-old male child underwent a deceased-donor kidney transplant and became infected with SARS-CoV-2 during the first day after surgery. Due to the increased risk of developing severe COVID-19, based on the predominance of Omicron and the patient's renal function, the child was treated with sotrovimab. The clinical course was successful and no adverse reactions were reported. CONCLUSIONS For the first time, we report the well-tolerated use of sotrovimab in children under 12 years old. As the pandemic affects children across the globe, urgent data on sotrovimab dosing in children with a higher risk of developing severe COVID-19 are needed.
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Affiliation(s)
- Costanza Di Chiara
- Department for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University of Padua, 35128 Padua, Italy; (M.D.P.); (C.G.); (D.D.)
| | - Daniele Mengato
- Hospital Pharmacy Department, University Hospital of Padova, 35121 Padua, Italy; (D.M.); (F.V.)
| | - Marica De Pieri
- Department for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University of Padua, 35128 Padua, Italy; (M.D.P.); (C.G.); (D.D.)
| | - Germana Longo
- Department for Women’s and Children’s Health, Division of Pediatric Nefrology Unit, University of Padua, 35128 Padua, Italy; (G.L.); (E.B.)
| | - Elisa Benetti
- Department for Women’s and Children’s Health, Division of Pediatric Nefrology Unit, University of Padua, 35128 Padua, Italy; (G.L.); (E.B.)
| | - Francesca Venturini
- Hospital Pharmacy Department, University Hospital of Padova, 35121 Padua, Italy; (D.M.); (F.V.)
| | - Carlo Giaquinto
- Department for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University of Padua, 35128 Padua, Italy; (M.D.P.); (C.G.); (D.D.)
| | - Daniele Donà
- Department for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University of Padua, 35128 Padua, Italy; (M.D.P.); (C.G.); (D.D.)
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Romani L, Calò Carducci FI, Chiurchiù S, Cursi L, De Luca M, Di Giuseppe M, Krzysztofiak A, Lancella L, Palma P, Vallesi L, Corsetti T, Campana A, Nicastri E, Rossi P, Bernardi S. Safety of Monoclonal Antibodies in Children Affected by SARS-CoV-2 Infection. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030369. [PMID: 35327741 PMCID: PMC8947030 DOI: 10.3390/children9030369] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Monoclonal antibody therapies for COVID-19 have been frequently used in adults, whereas there are little data regarding the safety or efficacy of monoclonal antibody treatments in pediatric patients affected by COVID-19. We report our experience in the administration of mAb as a treatment for SARS-CoV-2 infection in children aged from 24 days to 18 years old.
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Affiliation(s)
- Lorenza Romani
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
- Correspondence:
| | - Francesca Ippolita Calò Carducci
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Sara Chiurchiù
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Laura Cursi
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Maia De Luca
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Martina Di Giuseppe
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Andrzej Krzysztofiak
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Laura Lancella
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
| | - Paolo Palma
- Research Unit of Congenital and Perinatal Infections, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Leonardo Vallesi
- Hospital Pharmacy Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (L.V.); (T.C.)
| | - Tiziana Corsetti
- Hospital Pharmacy Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (L.V.); (T.C.)
| | - Andrea Campana
- Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Emanuele Nicastri
- National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, 00149 Rome, Italy;
| | - Paolo Rossi
- Chair of Pediatrics, Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Stefania Bernardi
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.I.C.C.); (S.C.); (L.C.); (M.D.L.); (M.D.G.); (A.K.); (L.L.); (S.B.)
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9
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Vitte J, Vibhushan S, Bratti M, Montero-Hernandez JE, Blank U. Allergy, Anaphylaxis, and Nonallergic Hypersensitivity: IgE, Mast Cells, and Beyond. Med Princ Pract 2022; 31:501-515. [PMID: 36219943 PMCID: PMC9841766 DOI: 10.1159/000527481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/06/2022] [Indexed: 01/20/2023] Open
Abstract
IgE-mediated type I hypersensitivity reactions have many reported beneficial functions in immune defense against parasites, venoms, toxins, etc. However, they are best known for their role in allergies, currently affecting almost one third of the population worldwide. IgE-mediated allergic diseases result from a maladaptive type 2 immune response that promotes the synthesis of IgE antibodies directed at a special class of antigens called allergens. IgE antibodies bind to type I high-affinity IgE receptors (FcεRI) on mast cells and basophils, sensitizing them to get triggered in a subsequent encounter with the cognate allergen. This promotes the release of a large variety of inflammatory mediators including histamine responsible for the symptoms of immediate hypersensitivity. The development of type 2-driven allergies is dependent on a complex interplay of genetic and environmental factors at barrier surfaces including the host microbiome that builds up during early life. While IgE-mediated immediate hypersensitivity reactions are undoubtedly at the origin of the majority of allergies, it has become clear that similar responses and symptoms can be triggered by other types of adaptive immune responses mediated via IgG or complement involving other immune cells and mediators. Likewise, various nonadaptive innate triggers via receptors expressed on mast cells have been found to either directly launch a hypersensitivity reaction and/or to amplify existing IgE-mediated responses. This review summarizes recent findings on both IgE-dependent and IgE-independent mechanisms in the development of allergic hypersensitivities and provides an update on the diagnosis of allergy.
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Affiliation(s)
- Joana Vitte
- Aix-Marseille Université, IRD, APHM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
- IDESP, INSERM UMR UA 11, Montpellier, France
| | - Shamila Vibhushan
- Université Paris Cité - Centre de Recherche sur l'Inflammation, INSERM UMRS 1149, CNRS EMR8252, Laboratoire d'Excellence Inflamex, Paris, France
| | - Manuela Bratti
- Université Paris Cité - Centre de Recherche sur l'Inflammation, INSERM UMRS 1149, CNRS EMR8252, Laboratoire d'Excellence Inflamex, Paris, France
| | - Juan Eduardo Montero-Hernandez
- Université Paris Cité - Centre de Recherche sur l'Inflammation, INSERM UMRS 1149, CNRS EMR8252, Laboratoire d'Excellence Inflamex, Paris, France
| | - Ulrich Blank
- Université Paris Cité - Centre de Recherche sur l'Inflammation, INSERM UMRS 1149, CNRS EMR8252, Laboratoire d'Excellence Inflamex, Paris, France
- *Ulrich Blank,
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