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    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

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    Author
    Klein, Matthew N
    Wang, 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
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    Date
    2021-04-23
    Journal
    Journal of Clinical Pathology
    Publisher
    BMJ Publishing Group
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1136/jclinpath-2020-207356
    https://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.
    Keyword
    COVID-19
    antibodies
    blood transfusion
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15533
    ae974a485f413a2113503eed53cd6c53
    10.1136/jclinpath-2020-207356
    Scopus Count
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    UMB Open Access Articles
    UMB Coronavirus Publications

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