Immunotherapy for COVID-19: Evolving treatment of viral infection and associated adverse immunological reactions

This review on COVID-19 immunotherapy enables a comparative analysis of the short-list of currently approved major vaccines. These include the Pfizer and Moderna first mRNA vaccines under FDA purview and the Oxford/AstraZeneca simian adenovirus-vectored vaccine (under UK-MHPRA guidance), all produce...

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Bibliographic Details
Published in:Transfusion and apheresis science 2021-04, Vol.60 (2), p.103093-103093, Article 103093
Main Author: Putter, Jeffrey S.
Format: Article
Language:English
Subjects:
Antibodies, Viral - immunology
Coronavirus convalescent plasma
Coronavirus covid-19
Coronavirus inflammation
Coronavirus neutralizing antibodies
Coronavirus vaccines
Covid 19 lymphopenia
COVID-19 - epidemiology
COVID-19 - immunology
COVID-19 - prevention & control
COVID-19 Vaccines - adverse effects
COVID-19 Vaccines - chemistry
COVID-19 Vaccines - therapeutic use
Humans
SARS-CoV-2 - immunology
Vaccination
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Summary:This review on COVID-19 immunotherapy enables a comparative analysis of the short-list of currently approved major vaccines. These include the Pfizer and Moderna first mRNA vaccines under FDA purview and the Oxford/AstraZeneca simian adenovirus-vectored vaccine (under UK-MHPRA guidance), all produced in record time, being safe and effective. The Pfizer and Moderna double dose vaccines have the clear edge in treatment efficacy, being in the 90% range compared to AstraZeneca in the average 70%. However, the AZ double dose vaccine has significant advantages with respect to lower cost and stability in storage. We enumerate several potential advances in the technology of the manufacturers: (1) combination vaccines such as testing AstraZeneca’s product with a component of the Russian’s Sputnik V to achieve durable immunity; (2) the potential for single dose vaccines coming on-line, and with Johnson & Johnson/Janssen; and (3) the need for refined thermotolerant formulations obviating the need for cold storage. As an adjunct to vaccinotherapy, affinity adsorption column technology is another facet recruited in the processing of corona convalescent plasma/cryosupernatant to concentrate neutralizing antibodies against the virus. Clinical trials, to date, of infected patients have been indeterminate as to whether plasmapheresis-based products are effective or not. This is due to the failure to standardize the composition of the plasma derived component, ambiguous clinical indications for use in human subjects, and inconsistent timing of administration in the course of the infection. Known T-cell lymphopenia, which is attendant to progressive viral infection and immune driven inflammation, may be a quantitative surrogate biological marker as to when to start treatment. This is not only for initiating plasmapheresis-based therapeutics but also the judicious selection of ancillary pharmaceuticals, ie. monoclonal antibodies, recombinant proteins and anti-viral drugs.
ISSN:1473-0502
1878-1683
1473-0502
DOI:10.1016/j.transci.2021.103093