COVID‐19 convalescent plasma cohort study: Evaluation of the association between both donor and recipient neutralizing antibody titers and patient outcomes

Abstract

Background Current evidence regarding COVID‐19 convalescent plasma (CCP) transfusion practices is limited and heterogeneous. We aimed to determine the impact of the use of CCP transfusion in patients with previous circulating neutralizing antibodies (nAbs) in COVID‐19. Methods Prospective cohort including 102 patients with COVID‐19 transfused with ABO compatible CCP on days 0–2 after enrollment. Clinical status of patients was assessed using the adapted World Health Organization (WHO) ordinal scale on days 0, 5, and 14. The nAbs titration was performed using the cytopathic effect‐based virus neutralization test with SARS‐CoV‐2 (GenBank MT126808.1). The primary outcome was clinical improvement on day 14, defined as a reduction of at least two points on the adapted WHO ordinal scale. Secondary outcomes were the number of intensive care unit (ICU)‐free days and the number of invasive mechanical ventilation‐free days. Results Both nAbs of CCP units transfused (p < 0.001) and nAbs of patients before CCP transfusions (p = 0.028) were associated with clinical improvements by day 14. No significant associations between nAbs of patients or CCP units transfused were observed in the number of ICU or mechanical ventilation‐free days. Administration of CCP units after 10 days of symptom onset resulted in a decrease in ICU‐free days (p < 0.001) and mechanical ventilation‐free days (p < 0.001). Conclusion Transfusion of high titer nAbs CCP units may be a determinant in clinical strategies against COVID‐19. We consider these data as useful parameters to guide future CCP transfusion practices.

SARS‐CoV‐2 neutralising antibody therapies: Recent advances and future challenges

“…A glimmer of hope emerged as, by the fifth day, an encouraging 18.6% of patients displayed improvement—a figure that soared to 45.1% by the fourteenth day. It is important to note that mild to moderate transfusion reactions were reported in 4.8% of the patients 77 …”

“…It is important to note that mild to moderate transfusion reactions were reported in 4.8% of the patients. 77 In the nascent days of the pandemic, CP therapy emerged as a beacon of hope for combatting SARS-CoV-2 infections. The underlying premise was that neutralising antibodies from recovered individuals could be passively transferred to newly-infected patients, thereby attenuating viral load and fostering clinical improvement and recovery.…”

Review of therapeutic mechanisms and applications based on SARS-CoV-2 neutralizing antibodies

“…By the fifth day, 19 (18.6%) patients had improved, and 45.1% of the patients had improved by the fourteenth day. Five (4.8%) patients experienced mild to moderate transfusion reactions ( Yokoyama et al, 2021 ).…”

Dynamics of Cytokine, SARS-CoV-2-Specific IgG, and Neutralizing Antibody Levels in COVID-19 Patients Treated with Convalescent Plasma

“…Passive immunization using convalescent plasma from recovered patients (convalescent plasma) containing high levels of neutralizing antibodies is a well-known treatment for a variety of emerging infectious diseases, including those associated with H1N1, SARS-CoV-1, MERS-CoV-1, Ebolavirus, and SARS-CoV-2 [ 11 , 12 , 13 , 14 ]. Furthermore, recent evidence suggests that circulating neutralizing antibodies in the serum of recovered COVID-19 patients can effectively inhibit the virus and may have potential benefits for COVID-19 treatment [ 15 ]. Neutralizing antibodies are specialized types of immune-system-generated antibodies, crucial for shielding the body against harmful pathogens, including viruses and infectious particles.…”