The following is a summary of “Clinical outcomes and immunological features of COVID-19 patients receiving B-cell depletion therapy during the Omicron era,” published in the December 2023 issue of Infectious Disease by Lee et al.

Despite the widespread use of B-cell depletion therapy (BCDT), the Omicron era casts a shadow over its impact on COVID-19 patients: their clinical outcomes and immune response remain unsurprising.

Researchers conducted a retrospective study to explore the impact of BCDT on COVID-19 outcomes and immune responses during the Omicron surge.

They compared clinical outcomes in 149 COVID-19 patients receiving BCDT (the BCDT group) with those having the same underlying conditions but not treated with BCDT (the non-BCDT group). Also, 50 COVID-19 patients on BCDT and 50 immunocompetent controls were analyzed for immune responses using enzyme-linked immunosorbent assay and flow cytometry.

The results showed a higher frequency of severe to critical COVID-19 in the BCDT group compared to the non-BCDT group (41.9% vs. 28.3%, P=0.030). BCDT demonstrated an independent risk factor for severe to critical COVID-19 (aOR  2.21, 95% CI 1.21–4.04, P=0.010) and COVID-19-related mortality (aOR 4.03, 95% CI 1.17–13.86, P=0.027). BCDT patients showed lower anti-S1 IgG and higher activated CD4+ T-cell proportions than controls.

Investigators concluded that omicron’s blow was harsher for BCDT patients, likely due to weakened humoral immunity and overactive T cells. 

Source: tandfonline.com/doi/full/10.1080/23744235.2023.2276784