Special Issue "SARS-CoV-2 Inside and Outside the Respiractory Tract: From Diagnostics to Therapies"

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "SARS-CoV-2 and COVID-19".

Deadline for manuscript submissions: 31 October 2021.

Special Issue Editor

Dr. Daniele Focosi
E-Mail Website
Guest Editor
North-Western Tuscany Blood Bank, Pisa University Hospital, 56124 Pisa, Italy
Interests: emerging viral infections; SARS-CoV-2; convalescent plasma; passive immunotherapies; vaccines
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

SARS-CoV-2 infects the upper respiratory tract, but its life cycle includes extra-respiratory stages. Biological matrices other than the nasopharyngeal swab are relevant for diagnostics and therapeutics. Plasma factors are involved in several features of COVID-19, ranging from diagnostics (serology assays), through thrombotic complications (e.g., anti-ADAMTS13 autoantibodies), to therapy. Systemic neutralizing antibodies are one of the key treatments for COVID-19, ranging from monoclonal antibodies to convalescent plasma. Nevertheless, convalescent plasma also contains many more factors that affect outcomes, ranging from decoy viral receptors (e.g., ACE2-positive exosomes) to autoantibodies (e.g., anti-interferon antibodies), and from factors affecting heparin therapy (e.g., antithrombin III) to symbiont viruses that regulate immune competence (e.g., TTV). Adenovirus-based COVID-19 vaccines have also been recently associated with rare thrombosis (anti-PF4 antibodies), whose pathogenesis remains to be investigated. In this Special Issue, we present findings related to the interaction between SARS-CoV-2 and different tissues.

Dr. Daniele Focosi
Guest Editor

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Keywords

  • SARS-CoV-2
  • antigen assays
  • molecular assay
  • neutralizing antibodies
  • plasma factors
  • convalescent plasma
  • thrombosis

Published Papers (6 papers)

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Editorial

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Editorial
SARS-CoV-2 Variants: A Synopsis of In Vitro Efficacy Data of Convalescent Plasma, Currently Marketed Vaccines, and Monoclonal Antibodies
Viruses 2021, 13(7), 1211; https://doi.org/10.3390/v13071211 - 23 Jun 2021
Cited by 4 | Viewed by 1728
Abstract
We summarize here in vitro evidences of efficacy for convalescent plasma, currently approved vaccines and monoclonal antibodies against SARS-CoV-2 variants of concern (VOC: B.1.1.7, B.1.351, P.1, and B.1.617.2), variants of interest (VOI: B.1.427/B.1.429, P.2, B.1.525, P.3, B.1.526, and B.1.671.1), and other strains (B.1.1.298 [...] Read more.
We summarize here in vitro evidences of efficacy for convalescent plasma, currently approved vaccines and monoclonal antibodies against SARS-CoV-2 variants of concern (VOC: B.1.1.7, B.1.351, P.1, and B.1.617.2), variants of interest (VOI: B.1.427/B.1.429, P.2, B.1.525, P.3, B.1.526, and B.1.671.1), and other strains (B.1.1.298 and B.1.258delta). While waiting from real world clinical efficacy, these data provide guidance for the treating physician. Full article

Research

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Communication
Antibody-Mediated Neutralization of Authentic SARS-CoV-2 B.1.617 Variants Harboring L452R and T478K/E484Q
Viruses 2021, 13(9), 1693; https://doi.org/10.3390/v13091693 (registering DOI) - 26 Aug 2021
Viewed by 219
Abstract
The capacity of convalescent and vaccine-elicited sera and monoclonal antibodies (mAb) to neutralize SARS-CoV-2 variants is currently of high relevance to assess the protection against infections. We performed a cell culture-based neutralization assay focusing on authentic SARS-CoV-2 variants B.1.617.1 (Kappa), B.1.617.2 (Delta), B.1.427/B.1.429 [...] Read more.
The capacity of convalescent and vaccine-elicited sera and monoclonal antibodies (mAb) to neutralize SARS-CoV-2 variants is currently of high relevance to assess the protection against infections. We performed a cell culture-based neutralization assay focusing on authentic SARS-CoV-2 variants B.1.617.1 (Kappa), B.1.617.2 (Delta), B.1.427/B.1.429 (Epsilon), all harboring the spike substitution L452R. We found that authentic SARS-CoV-2 variants harboring L452R had reduced susceptibility to convalescent and vaccine-elicited sera and mAbs. Compared to B.1, Kappa and Delta showed a reduced neutralization by convalescent sera by a factor of 8.00 and 5.33, respectively, which constitutes a 2-fold greater reduction when compared to Epsilon. BNT2b2 and mRNA1273 vaccine-elicited sera were less effective against Kappa, Delta, and Epsilon compared to B.1. No difference was observed between Kappa and Delta towards vaccine-elicited sera, whereas convalescent sera were 1.51-fold less effective against Delta, respectively. Both B.1.617 variants Kappa (+E484Q) and Delta (+T478K) were less susceptible to either casirivimab or imdevimab. In conclusion, in contrast to the parallel circulating Kappa variant, the neutralization efficiency of convalescent and vaccine-elicited sera against Delta was moderately reduced. Delta was resistant to imdevimab, which, however, might be circumvented by combination therapy with casirivimab together. Full article
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Article
Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19—Poland, March–December 2020
Viruses 2021, 13(8), 1458; https://doi.org/10.3390/v13081458 - 27 Jul 2021
Viewed by 429
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19). This study aimed to characterize patients hospitalized with COVID-19 in Poland between March and December 2020, as well as to identify factors associated with COVID 19–related risk of in-hospital death. [...] Read more.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19). This study aimed to characterize patients hospitalized with COVID-19 in Poland between March and December 2020, as well as to identify factors associated with COVID 19–related risk of in-hospital death. This retrospective analysis was based on data from the hospital discharge reports on COVID-19 patients hospitalized in Poland between March and December 2020. A total of 116,539 discharge reports on patients hospitalized with COVID-19 were analyzed. Among patients with COVID-19, 21,490 (18.4%) died during hospitalization. Patients over 60 years of age (OR = 7.74; 95%CI: 7.37–8.12; p < 0.001), men (OR = 1.42; 95%CI: 1.38–1.47; p < 0.001) as well as those with cardiovascular diseases (OR = 1.51; 95%CI: 1.46–1.56; p < 0.001) or disease of the genitourinary system (OR = 1.39; 95%CI: 1.31–1.47; p < 0.001) had much higher odds of COVID 19–related risk of in-hospital death. The presence of at least one comorbidity more than doubled the COVID 19–related risk of in-hospital death (OR = 2.23; 95%CI: 2.14–2.32; p < 0.01). The following predictors of admission to ICU were found in multivariable analysis: age over 60 years (OR: 2.03; 95%CI: 1.90–2.16), male sex (OR: 1.79; 95%CI: 1.69–1.89), presence of at least one cardiovascular disease (OR: 1.26; 95%CI: 1.19–1.34), presence of at least one endocrine, nutritional and metabolic disease (OR: 1.17; 95%CI: 1.07–1.28). Full article
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Review

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Review
COVID-19 Convalescent Plasma Is More than Neutralizing Antibodies: A Narrative Review of Potential Beneficial and Detrimental Co-Factors
Viruses 2021, 13(8), 1594; https://doi.org/10.3390/v13081594 - 11 Aug 2021
Viewed by 571
Abstract
COVID-19 convalescent plasma (CCP) is currently under investigation for both treatment and post-exposure prophylaxis. The active component of CCP mediating improved outcome is commonly reported as specific antibodies, particularly neutralizing antibodies, with clinical efficacy characterized according to the level or antibody affinity. In [...] Read more.
COVID-19 convalescent plasma (CCP) is currently under investigation for both treatment and post-exposure prophylaxis. The active component of CCP mediating improved outcome is commonly reported as specific antibodies, particularly neutralizing antibodies, with clinical efficacy characterized according to the level or antibody affinity. In this review, we highlight the potential role of additional factors in CCP that can be either beneficial (e.g., AT-III, alpha-1 AT, ACE2+ extracellular vesicles) or detrimental (e.g., anti-ADAMTS13, anti-MDA5 or anti-interferon autoantibodies, pro-coagulant extracellular vesicles). Variations in these factors in CCP may contribute to varied outcomes in patients with COVID-19 and undergoing CCP therapy. We advise careful, retrospective investigation of such co-factors in randomized clinical trials that use fresh frozen plasma in control arms. Nevertheless, it might be difficult to establish a causal link between these components and outcome, given that CCP is generally safe and neutralizing antibody effects may predominate. Full article
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Review
Convalescent Plasma for Pregnant Women with COVID-19: A Systematic Literature Review
Viruses 2021, 13(7), 1194; https://doi.org/10.3390/v13071194 - 22 Jun 2021
Viewed by 706
Abstract
The treatment of COVID-19 is particularly critical in pregnant women, considering the potential teratogenic effects of antiviral agents and the immune-depression related with pregnancy. The aim of this review is to systematically examine the current evidence on the clinical use of convalescent plasma [...] Read more.
The treatment of COVID-19 is particularly critical in pregnant women, considering the potential teratogenic effects of antiviral agents and the immune-depression related with pregnancy. The aim of this review is to systematically examine the current evidence on the clinical use of convalescent plasma during pregnancy. The electronic databases Medline PubMed Advanced Search Builder, Scopus, Web Of Science and Google Scholar were searched (until 1 January 2021). Inclusion criteria were pregnant women with COVID-19 (or SARS-CoV-2 infection), in whom convalescent plasma (or hyperimmune plasma) was used as treatment. We searched clinical trial registries (censored 5 January 2021) for eligible studies under way. After elimination of duplications, the initial search yielded 79 potentially relevant records, of which 67 were subsequently excluded. The 12 remaining records were case reports involving 12 pregnancies. Six of the mothers were reported to be well, two were reported to have preeclampsia, and in one case each the maternal outcome was described as survival, clinical improvement, discharged with oxygen and rehabilitation. With regard to the neonates, two were declared to be well, four had transient morbidity, two were critically ill and one died; normal ongoing pregnancies, but no post-delivery information, were reported for the remaining three cases. Clinical trials under way or planned to investigate the use of convalescent plasma for COVID-19 during pregnancy are lacking. This is the first systematic review of the literature regarding the treatment of COVID-19 in pregnancy. The published literature data seem to indicate that convalescent plasma administered to pregnant women with severe COVID-19 provides benefits for both the mother and the fetus. The quality of the available studies is, however, very limited since they are all case reports and thus suffer from relevant reporting bias. Full article
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Review
Convalescent Plasma Transfusion for the Treatment of COVID-19 in Adults: A Global Perspective
Viruses 2021, 13(5), 849; https://doi.org/10.3390/v13050849 - 07 May 2021
Cited by 1 | Viewed by 772
Abstract
More than one year into the novel coronavirus disease 2019 (COVID-19) pandemic, healthcare systems across the world continue to be overwhelmed with soaring daily cases. The treatment spectrum primarily includes ventilation support augmented with repurposed drugs and/or convalescent plasma transfusion (CPT) from recovered [...] Read more.
More than one year into the novel coronavirus disease 2019 (COVID-19) pandemic, healthcare systems across the world continue to be overwhelmed with soaring daily cases. The treatment spectrum primarily includes ventilation support augmented with repurposed drugs and/or convalescent plasma transfusion (CPT) from recovered COVID-19 patients. Despite vaccine variants being recently developed and administered in several countries, challenges in global supply chain logistics limit their timely availability to the wider world population, particularly in developing countries. Given the measured success of conventional CPT in treating several infections over the past decade, recent studies have reported its effectiveness in decreasing the duration and severity of COVID-19 symptoms. In this review, we conduct a literature search of published studies investigating the use of CPT to treat COVID-19 patients from January 2020 to January 2021. The literature search identified 181 records of which 39 were included in this review. A random-effects model was used to aggregate data across studies, and mortality rates of 17 vs. 32% were estimated for the CPT and control patient groups, respectively, with an odds ratio (OR) of 0.49. The findings indicate that CPT shows potential in reducing the severity and duration of COVID-19 symptoms. However, early intervention (preferably within 3 days), recruitment of donors, and plasma potency introduce major challenges for its scaled-up implementation. Given the low number of existing randomized clinical trials (RCTs, four with a total of 319 patients), unanticipated risks to CPT recipients are highlighted and discussed. Nevertheless, CPT remains a promising COVID-19 therapeutic option that merits internationally coordinated RCTs to achieve a scientific risk–benefit consensus. Full article
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