Monoclonal antibody-mediated neutralization of SARS-CoV-2 in an IRF9-deficient child

R Lévy, P Zhang, P Bastard… - Proceedings of the …, 2021 - National Acad Sciences
R Lévy, P Zhang, P Bastard, K Dorgham, I Melki, A Hadchouel, GC Hartoularos, B Neven…
Proceedings of the National Academy of Sciences, 2021National Acad Sciences
We describe an unvaccinated child at risk for life-threatening COVID-19 due to an inherited
deficiency of IRF9, which governs ISGF-3–dependent responses to type I and III interferons
(IFN). She was admitted, with a high nasal SARS-CoV-2 load on day 1 of upper respiratory
tract infection. She was viremic on day 2 and received casirivimab and imdevimab. Her
clinical manifestations and viremia disappeared on days 3 and 4, respectively. Circulating
SARS-CoV-2 virus induced the expression of IFN-stimulated genes in leukocytes on day 1 …
We describe an unvaccinated child at risk for life-threatening COVID-19 due to an inherited deficiency of IRF9, which governs ISGF-3–dependent responses to type I and III interferons (IFN). She was admitted, with a high nasal SARS-CoV-2 load on day 1 of upper respiratory tract infection. She was viremic on day 2 and received casirivimab and imdevimab. Her clinical manifestations and viremia disappeared on days 3 and 4, respectively. Circulating SARS-CoV-2 virus induced the expression of IFN-stimulated genes in leukocytes on day 1, whereas the secretion of blood type I IFNs, which peaked on day 4, did not. Antibody-mediated SARS-CoV-2 neutralization is, therefore, sufficient to overcome a deficiency of antiviral IFNs.
National Acad Sciences