Coronavirus Disease 2019 Convalescent Plasma and the Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Titer

Bloch, Evan M.; Crowe, Elizabeth; Tobian, Aaron A.R.

doi:10.1093/infdis/jiab008

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…The beneficial effects of CCP are primarily associated with its neutralizing antibodies, which target SARS-CoV-2 and assist in viral clearance ( 62 , 63 ). Thus, persons who benefit the most from CCP are those treated early and who have not yet developed their own neutralizing antibodies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma

et al. 2022

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“…EIA or neutralizing antibody standards were provisionally set for donor units [103]. The use of donor plasma can soon outstrip the availability in highly endemic scenarios [202]. At screening, however, there is a considerable range of antibody levels [79,80,200,[203][204][205].…”

Section: Human Trials Of Passive Immunitymentioning

confidence: 99%

Passive Immunity Should and Will Work for COVID-19 for Some Patients

Cimolai¹

2021

CHI

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In the absence of effective antiviral chemotherapy and still in the context of emerging vaccines for severe acute respiratory syndrome-CoV-2 infections, passive immunotherapy remains a key treatment and possible prevention strategy. What might initially be conceived as a simplified donor-recipient process, the intricacies of donor plasma, IV immunoglobulins, and monoclonal antibody modality applications are becoming more apparent. Key targets of such treatment have largely focused on virus neutralization and the specific viral components of the attachment Spike protein and its constituents (e.g., receptor binding domain, N-terminal domain). The cumulative laboratory and clinical experience suggests that beneficial protective and treatment outcomes are possible. Both a dose-and a time-dependency emerge. Lesser understood are the concepts of bioavailability and distribution. Apart from direct antigen binding from protective immunoglobulins, antibody effector functions have potential roles in outcome. In attempting to mimic the natural but variable response to infection or vaccination, a strong functional polyclonal approach attracts the potential benefits of attacking antigen diversity, high antibody avidity, antibody persistence, and protection against escape viral mutation. The availability and ease of administration for any passive immunotherapy product must be considered in the current climate of need. There is never a perfect product, but yet there is considerable room for improving patient outcomes. Given the variability of human genetics, immunity, and disease, and given the nuances of the virus and its potential for change, passive immunotherapy can be developed that will be effective for some but not all patients. An understanding of such patient variability and limitations is just as important as the understanding of the direct interactions between immunotherapy and virus.

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COVID-19 convalescent plasma

Tobian

Cohn

Shaz

2022

Blood

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As the coronavirus disease (COVID-19) pandemic led to a global health crisis, there were limited treatment options and no prophylactic therapies for those exposed to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Convalescent plasma is quick to implement, potentially provides benefits, and has a good safety profile. The therapeutic potential of COVID-19 convalescent plasma (CCP) is likely mediated by antibodies through direct viral neutralization and Fc-dependent functions such as a phagocytosis, complement activation, and antibody-dependent cellular cytotoxicity. In the United States, CCP became one of the most common treatments with over half million units transfused despite limited efficacy data. More than a dozen randomized trials now demonstrate that CCP does not provide benefit for those with moderate to severe disease. However, similar to other passive antibody therapies, CCP is beneficial for early disease, when provided to elderly outpatients within 72 hours after symptom onset. Only high-titer CCP should be transfused. CCP should also be considered for immunosuppressed COVID-19 patients. CCP collected in proximity, by time and location, to the patient may be more beneficial due to SARS-CoV-2 variants. Additional randomized trial data are still accruing and should be incorporated with other trial data to optimize CCP indications.

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Coronavirus Disease 2019 Convalescent Plasma and the Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Titer

Cited by 5 publications

References 18 publications

Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma

Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma

Passive Immunity Should and Will Work for COVID-19 for Some Patients

COVID-19 convalescent plasma

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