Case Report: Neutralization of Autoantibodies Targeting G-Protein-Coupled Receptors Improves Capillary Impairment and Fatigue Symptoms After COVID-19 Infection

Figures

• 

  Figure 1. Blood pressure (systolic, diastolic, mmHg) before (A), during (B), and after treatment with BC 007 (C): a reduction of the diastolic blood pressure was observed after the elimination of functional active G-protein-coupled receptor autoantibodies [GPCR-AAb; w-week; dotted line: individual target level of systolic (red) and diastolic (blue) blood pressure].

• 

  Figure 2. Measurement of ocular parameters (capillary microcirculation, A–D; intraocular pressure, E): Capillary microcirculation of the macula and peripapillary region, scanned by optical coherence tomography-angiography (OCT-A): vessel density (VD) was monitored in the three layers of the macula (superficial vascular plexus, SVP, A; intermediate capillary plexus, ICP, B; deep capillary plexus, DCP, C) and peripapillary region (D). Vessel density of the macula was reduced after COVID-19 infection compared to the preexisting data of 2018. After treatment with BC 007, the VD increased in all the three layers of the macula and peripapillary region, being stable over at least during the observation period of 4 weeks (gray: range of VD in normal eyes, dotted line: reference level of VD after COVID-19 infection). Data of the left eye are shown as the quality of the OCT-A scans of the right eye were not exploitable due to a hindered fixation of the patient by the presence of cataract. (E) Intraocular pressure (IOP, mmHg; measured by Goldmann applanation tonometry) was monitored before and after treatment with BC 007; reference data of 2018 (EGR, ISSN 2191-5008, CS-2011; NTC00494923) were…

• 

  Figure 3. Autoantibodies (AAbs) against G-protein coupled receptors (ß2-AAb, AT-1-AAb, α1-AAb, MAS-AAb, and M2-AAb) before (at the day of infusion, before the treatment, single star) and after treatment with BC 007 [after 2 h (double star), 1 day, 2 days, and 1–4 weeks]: functional activity of the positive and negative chronotrope effect of the different AAbs were reduced even after 2 h and functionally inactive at least over the observation period of 4 weeks (cut-off 1.8 beats/15 s); w-week.

• 

  Figure 4. Chronic fatigue syndrome (CFS) was assessed by the Canadian Criteria, Chalder Fatigue Scale, and the Bell Score before and after treatment with BC 007: CFS was reduced after treatment with BC 007, being absent after 4 weeks; the lower is the Canadian Criteria and Chalder Fatigue Scale, the lower is the CFS; the higher the Bell Score, the lower is the CFS; w, week; the range of the scores—Canadian Criteria Score: 0 (best)–34 (worst): Chalder Fatigue Scale: 0 (best)–33 (worst); Bell Score: 100 (best)–0 (worst).