Screening forSARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program

Author(s):Show less -

Wendel, Silvano ^[1] ; Kutner, Jose Mauro ^[2] ; Machado, Rafael ^[3] ; Fontao-Wendel, Rita ^[1] ; Bub, Carolina ^[2] ; Fachini, Roberta ^[1] ; Yokoyama, Ana ^[2] ; Candelaria, Gabriela ^[1] ; Sakashita, Araci ^[2] ; Achkar, Ruth ^[1] ; Hamerschlak, Nelson ^[2] ; Scuracchio, Patricia ^[1] ; Amaral, Marcelo ^[1] ; Dal Ben, Mirian ^[4] ; Araujo, Danielle ^[3] ; Soares, Camila ^[3] ; Camargo, Anamaria ^[4] ; Kallas, Esper ^[5] ; Durigon, Edison ^[3] ; Reis, Luiz Fernando ^[4] ; Rizzo, Luiz Vicente ^[6]

Affiliation

^[1] Hosp Sirio Libanes Blood Bank, Rua Adma Jafet 91, BR-01308050 Sao Paulo - Brazil

^[2] Hosp Israelita Albert Einstein Blood Bank, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Inst Biomed Sci, Dept Microbiol, Sao Paulo - Brazil

^[4] Hosp Sirio Libanes, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Infectious Dis Dept, Sao Paulo - Brazil

^[6] Albert Einstein Jewish Inst Educ & Res, Sao Paulo - Brazil

• Document type: Journal article
• Source: Transfusion; v. 60, n. 12, p. 2938-2951, DEC 2020.
• Web of Science Citations: 1

Abstract

Background Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. Methods and Materials Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for >= 14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. Results Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%;P= .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody >= 160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P< .05), probably denoting a ``golden period{''} for CCP collection (<= 28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. Conclusions RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody. (AU)

• FAPESP's process: 20/06409-1 - Evaluation of humoral immune response and inflammatory response in patients with confirmed diagnosis of COVID-19 at Hospital Sírio Libanês and correlation with disease severity
• Grantee: Edison Luiz Durigon
• Support type: Regular Research Grants
• FAPESP's process: 18/23680-0 - Standardization of Sherlock technique (Specific High-Sensitivity Enzymatic Reporter Unlocking) using the Cas13a protein for the diagnosis of respiratory syncytial virus in pediatric patients
• Grantee: Camila Pereira Soares
• Support type: Scholarships in Brazil - Master
• FAPESP's process: 16/20045-7 - Antigen discovery and development of serological diagnostic methods and vaccine approaches against the Zika Virus (ZIKV)
• Grantee: Luis Carlos de Souza Ferreira
• Support type: Research Projects - Thematic Grants
• FAPESP's process: 17/24769-2 - Zika virus in postpartum women and newborns: seroepidemiology and molecular characterization
• Grantee: Rafael Rahal Guaragna Machado
• Support type: Scholarships in Brazil - Doctorate (Direct)