Sao Paulo, June 24: In a rare case, Brazilian scientists used breast milk to treat COVID-19 in a woman with a rare genetic condition that renders her immune system unable to fight off viruses and other pathogens.
The patient who was diagnosed with COVID-19, in March 2021, tested positive for 124 days by RT-PCR. The team from the University of Campinas (UNICAMP) in Sao Paulo advised her to take 30 milliliters of breast milk every three hours for a week. The breast milk was donated by a woman who had been vaccinated against SARS-CoV-2.
Breast milk improved her immunity levels and helped her to be negative within a week, according to the case reported in an article published in the journal Viruses.
“I have been this patient since she was a child, and I was very worried when she told me she had COVID-19. The innate immune error from which she suffers deregulates her entire defense system. His inflammatory response is defective, with few cells going to the site of inflammation and low antibody production. Depending on their virulence, infectious agents can lead to two outcomes in such cases – chronic infection or death,” said pediatrician Maria Marluce dos Santos Vilela, professor at the UNICAMP Faculty of Medicine.
Vilela explained that the immune system in humans and other mammals normally produces five types of immunoglobulin antibodies (IgM, IgG, IgA, IgE and IgD).
Patients with immune dysregulation syndromes have IgE deficiency and in some cases a complete absence of IgA, the main antibody that neutralizes viruses and other pathogens. IgAs are commonly present in breast milk, as well as in respiratory and gastrointestinal secretions.
The syndromes also result in very low production of IgG, normally the most abundant antibody in the blood and responsible for recognizing and neutralizing antigens with which the body has previously come into contact.
Only 157 cases of the same type as that of this patient have been described worldwide, as reported in an article published in the Journal of Allergy and Clinical Immunology.
Vilela said the patient was deliberately treated at home to avoid a hospital-related bacterial infection, which would have worsened her condition.
During the first 15 days of infection, the patient had fever, loss of appetite, cough and asthenia (lack of energy, weakness), but to the surprise and relief of Vilela, her lungs and other systems were unaffected. After two months, her condition was the same and the researchers decided to treat her with convalescent plasma.
Treatment involves a transfusion of IgG and other antibodies produced by people who have recovered from COVID-19.
While her symptoms improved, with a reduction in blood inflammatory markers, after the procedure, her RT-PCR test remained positive even after 15 days. The patient still had mild symptoms, as well as signs of adynamia, general muscle weakness associated with prolonged infectious processes.
That’s when the team decided to do an experimental treatment using breast milk to boost her IgA levels. The experiment was based on a paper that showed breastfeeding women immunized with Pfizer’s COVID-19 vaccine produced milk with a reasonable amount of IgA.
“We asked him to take the milk orally and keep it in his mouth for several minutes. IgA works like a broom in that it sticks to pathogens throughout the gastrointestinal tract so that anything inappropriate is eliminated in the faeces. We decided on a three-hour interval between doses, except at night, so as not to give the virus a chance to replicate,” Vilela said.
The patient tested negative after a week, then twice 10 days apart.