Kinetics of SARS-CoV-2 antibody responses pre-COVID-19 and post-COVID-19 convalescent plasma transfusion in patients with severe respiratory failure: an observational case-control study
Author
Klein, Matthew NWang, Elizabeth Wenqian
Zimand, Paul
Beauchamp, Heather
Donis, Caitlin
Ward, Matthew D
Martinez-Hernandez, Aidaelis
Tabatabai, Ali
Baddley, John W
Bloch, Evan M
Mullins, Kristin E
Fontaine, Magali J
Date
2021-04-23Journal
Journal of Clinical PathologyPublisher
BMJ Publishing GroupType
Article
Metadata
Show full item recordSee at
https://doi.org/10.1136/jclinpath-2020-207356https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072701/
Abstract
Aims: While the SARS-CoV-2 pandemic may be contained through vaccination, transfusion of convalescent plasma (CCP) from individuals who recovered from COVID-19 (CCP) is considered an alternative treatment. We investigate if CCP transfusion in patients with severe respiratory failure increases plasma titres of SARS-CoV-2 antibodies and improves clinical outcomes. Methods: Patients with COVID-19 (n=34) were consented for CCP transfusion and serial blood draws pretransfusion and post-transfusion. Plasma SARS-CoV-2 antireceptor binding domain (RBD) IgG and IgM titres were measured by ELISA serially, and compared with serial plasma titre levels from control patients (n=68). The primary outcome was survival at 30 days, and secondary outcomes were length of ventilator and/or extracorporeal membrane oxygenation (ECMO) support, length of stay (LOS) in the hospital and in the intensive care unit (ICU). Outcomes were compared with matched control patients (n=34). Kinetics of antibodies and clinical outcomes were compared using LOess regression and ORs, respectively. Results: Prior to CCP transfusion, 74% of patients were anti-RBD seropositive for IgG (median 1:3200), and 81% were anti-RBD IgM seropositive (median 1:320), while 16% were seronegative. The kinetics of antibody titres in CCP recipients were similar to controls. CCP recipients presented with similar survival, duration on ventilatory and/or ECMO support, as well as ICU and hospital LOS compared with controls. Conclusions: CCP transfusion did not increase the kinetics of SARS-CoV2 antibodies and did not result in improved clinical outcomes in patients with COVID-19 with severe respiratory failure, suggesting that CCP may not be indicated in this category of patients.Rights/Terms
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Identifier to cite or link to this item
http://hdl.handle.net/10713/15533ae974a485f413a2113503eed53cd6c53
10.1136/jclinpath-2020-207356
Scopus Count
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