Clearance of Persistent SARS-CoV-2 RNA Detection in a NFκB-Deficient Patient in Association with the Ingestion of Human Breast Milk: A Case Report.

Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil. Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil. World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA. Oswaldo Cruz Foundation (Fiocruz-SP), Ribeirão Preto 14049-900, Brazil. Department of Public Health Emergency, Preparedness and Disaster, PAHO/WHO, Brasilia 70312-970, Brazil. Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil. One Health Laboratory, Feevale University, Novo Hamburgo 93510-235, Brazil. Tropical Medicine Institute, Medical School, University of São Paulo, São Paulo 5403-907, Brazil. Department of Infectious and Parasitic Disease, Medical School, University of São Paulo, São Paulo 05403-000, Brazil. Department of Zoology, University of Oxford, Oxford OX1 2JD, UK. MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London SW7 2AZ, UK. Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil. Division of Infectious Diseases, University of Campinas, Campinas 13083-887, Brazil. Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo, São Paulo 05403-000, Brazil. Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX 77555, USA. Biodiversity Research Centre, Federal University of Roraima, Boa Vista 72000-000, Brazil. Experimental Medicine Research Cluster (EMRC), University of Campinas, Campinas 13083-862, Brazil. Hub of Global Health (HGH), University of Campinas, Campinas 13083-862, Brazil.

Viruses. 2022;(5)
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Abstract

Currently, there are no evidence-based treatment options for long COVID-19, and it is known that SARS-CoV-2 can persist in part of the infected patients, especially those with immunosuppression. Since there is a robust secretion of SARS-CoV-2-specific highly-neutralizing IgA antibodies in breast milk, and because this immunoglobulin plays an essential role against respiratory virus infection in mucosa cells, being, in addition, more potent in neutralizing SARS-CoV-2 than IgG, here we report the clinical course of an NFκB-deficient patient chronically infected with the SARS-CoV-2 Gamma variant, who, after a non-full effective treatment with plasma infusion, received breast milk from a vaccinated mother by oral route as treatment for COVID-19. After such treatment, the symptoms improved, and the patient was systematically tested negative for SARS-CoV-2. Thus, we hypothesize that IgA and IgG secreted antibodies present in breast milk could be useful to treat persistent SARS-CoV-2 infection in immunodeficient patients.

Methodological quality

Publication Type : Case Reports

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