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

Janine S Sabino; Mariene R Amorim; William M de Souza; Lia F Marega; Luciana S Mofatto; Daniel A Toledo-Teixeira; Julia Forato; Rodrigo G Stabeli; Maria Laura Costa; Fernando R Spilki; Ester C Sabino; Nuno R Faria; Bruno D Benites; Marcelo Addas-Carvalho; Raquel S B Stucchi; Dewton M Vasconcelos; Scott C Weaver; Fabiana Granja; José Luiz Proenca-Modena; Maria Marluce Dos S Vilela

doi:10.3390/v14051042

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

Viruses. 2022 May 13;14(5):1042. doi: 10.3390/v14051042.

Authors

Janine S Sabino¹, Mariene R Amorim², William M de Souza³, Lia F Marega¹, Luciana S Mofatto², Daniel A Toledo-Teixeira², Julia Forato², Rodrigo G Stabeli^{4

5}, Maria Laura Costa⁶, Fernando R Spilki⁷, Ester C Sabino^{8

9}, Nuno R Faria^{9

10

11}, Bruno D Benites¹², Marcelo Addas-Carvalho¹², Raquel S B Stucchi¹³, Dewton M Vasconcelos¹⁴, Scott C Weaver^{3

15}, Fabiana Granja^{2

16}, José Luiz Proenca-Modena^{2

17

18}, Maria Marluce Dos S Vilela¹

Affiliations

¹ Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil.
² Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil.
³ World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA.
⁴ Oswaldo Cruz Foundation (Fiocruz-SP), Ribeirão Preto 14049-900, Brazil.
⁵ Department of Public Health Emergency, Preparedness and Disaster, PAHO/WHO, Brasilia 70312-970, Brazil.
⁶ Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil.
⁷ One Health Laboratory, Feevale University, Novo Hamburgo 93510-235, Brazil.
⁸ Tropical Medicine Institute, Medical School, University of São Paulo, São Paulo 5403-907, Brazil.
⁹ Department of Infectious and Parasitic Disease, Medical School, University of São Paulo, São Paulo 05403-000, Brazil.
¹⁰ Department of Zoology, University of Oxford, Oxford OX1 2JD, UK.
¹¹ MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London SW7 2AZ, UK.
¹² Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil.
¹³ Division of Infectious Diseases, University of Campinas, Campinas 13083-887, Brazil.
¹⁴ Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo, São Paulo 05403-000, Brazil.
¹⁵ Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX 77555, USA.
¹⁶ Biodiversity Research Centre, Federal University of Roraima, Boa Vista 72000-000, Brazil.
¹⁷ Experimental Medicine Research Cluster (EMRC), University of Campinas, Campinas 13083-862, Brazil.
¹⁸ Hub of Global Health (HGH), University of Campinas, Campinas 13083-862, Brazil.

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.

Keywords: IgA; NFκB-deficiency; breast milk; immunosuppression; persistent SARS-CoV-2 infection.

Publication types

Case Reports
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Antibodies, Viral
COVID-19* / complications
Eating
Female
Humans
Immunoglobulin A
Immunoglobulin G
Milk, Human
NF-kappa B
Post-Acute COVID-19 Syndrome
RNA, Viral
SARS-CoV-2* / genetics

Substances

Antibodies, Viral
Immunoglobulin A
Immunoglobulin G
NF-kappa B
RNA, Viral

Supplementary concepts

SARS-CoV-2 variants

Abstract

Publication types

MeSH terms

Substances

Supplementary concepts

Grants and funding