Commercial immunoglobulin products now contain neutralising antibodies against SARS-CoV-2 spike protein which are detectable in patient serum

Upasani, Vinit; OʼSullivan, Mary J.; Moreira, Fernando; Workman, Sarita; Symes, Andrew; Burns, Siobhan O.; Tadros, Susan; McCoy, Laura E.; Lowe, David M.

doi:10.1101/2022.09.22.22280216

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…The difficulty in obtaining CCP and the potential for blood‐borne virus transmission make IVIG an attractive alternative. In a study by Upasani et al., 62 it was demonstrated that numerous commercially available IVIG products contain high titers of neutralizing antibodies but with a significant batch‐to‐batch variation. Furthermore, the characterization of recipient‐neutralizing antibody titers before and after transfusion demonstrated a marked increase in neutralization, similar to that in healthy donors.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, 50% of their cohort did not respond to combination therapy, requiring the addition of a second antiviral for success, which was measured as an increase in the PCR cycle threshold to an undefined level. 59 Also worthy of particular note, Mikulska et al 60 Antiviral therapy in combination with convalescent plasma was described in 11 individuals, five of whom were cohorts of patients with B-cell malignancy treated with r/nirmatrelvir and CCP, as described by Huygens et al, 61 and had a high success rate of 80% (4 of 5 cases). Considering all cases, the success rates for this approach were similar, with 8/11 (73%) patients responding.…”

Section: Multi-modal Therapy With An Antiviral In Combination With Ne...mentioning

confidence: 99%

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Antiviral therapies for the management of persistent coronavirus disease 2019 in immunocompromised hosts: A narrative review

Kinsella,

Moso,

Morrissey

et al. 2024

Transplant Infectious Dis

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Antiviral agents with activity against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) have played a critical role in disease management; however, little is known regarding the efficacy of these medications in the treatment of SARS‐CoV‐2 infection in immunocompromised patients, particularly in the management of persistent SARS‐CoV‐2 positivity.This narrative review discusses the management of persistent coronavirus disease 2019 in immunocompromised hosts, with a focus on antiviral therapies. We identified 84 cases from the literature describing a variety of approaches, including prolonged antiviral therapy (n = 11), combination antivirals (n = 13), and mixed therapy with antiviral and antibody treatments (n = 60). A high proportion had an underlying haematologic malignancy (n = 67, 80%), and were in receipt of anti‐CD20 agents (n = 51, 60%). Success was reported in 70 cases (83%) which varied according to the therapy type. Combination therapies with antivirals may be an effective approach for individuals with persistent SARS‐CoV‐2 positivity, particularly those that incorporate treatments aimed at increasing neutralizing antibody levels. Any novel approaches taken to this difficult management dilemma should be mindful of the emergence of antiviral resistance.

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Section: Resultsmentioning

confidence: 99%

Section: Multi-modal Therapy With An Antiviral In Combination With Ne...mentioning

confidence: 99%

Antiviral therapies for the management of persistent coronavirus disease 2019 in immunocompromised hosts: A narrative review

Kinsella,

Moso,

Morrissey

et al. 2024

Transplant Infectious Dis

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“…5,19 Collectively, contemporary clinical data provide evidence to support the utility of high-titer convalescent plasma including vax-plasma as antibody replacement therapy in immunocompromised patients. 17,20,21…”

Section: Resultsmentioning

confidence: 99%

Outpatient treatment with concomitant vaccine-boosted convalescent plasma for patients with immunosuppression and COVID-19

Ripoll,

Tulledge-Scheitel,

Stephenson

et al. 2023

Preprint

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Although severe coronavirus disease 19 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. Additionally, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 (vax-plasma). Thus, we report the clinical outcome of 208 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19 specific therapeutics (standard of care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 1% (1 of 123 patients) in the vax-plasma group and 6% (5 of 85 patients) in the standard of care group, which corresponded to a relative risk reduction of 83%. Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (196 of 208 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19 specific therapies reduced the risk of disease progression leading to hospitalization.

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Polyclonal immunoglobulins for COVID-19 pre-exposure prophylaxis in immunocompromised patients

Focosi¹,

Franchini

2023

Transfusion and Apheresis Science

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Commercial immunoglobulin products now contain neutralising antibodies against SARS-CoV-2 spike protein which are detectable in patient serum

Cited by 3 publications

References 9 publications

Antiviral therapies for the management of persistent coronavirus disease 2019 in immunocompromised hosts: A narrative review

Antiviral therapies for the management of persistent coronavirus disease 2019 in immunocompromised hosts: A narrative review

Outpatient treatment with concomitant vaccine-boosted convalescent plasma for patients with immunosuppression and COVID-19

Polyclonal immunoglobulins for COVID-19 pre-exposure prophylaxis in immunocompromised patients

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