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

Author(s):Show less -

Yokoyama, Ana Paula H. ; Wendel, Silvano ^[1] ; Bonet-Bub, Carolina ^[2] ; Fachini, Roberta M. ^[1] ; Dametto, Ana Paula F. ^[2] ; Blumm, Fernando ^[3] ; Dutra, Valeria F. ^[2] ; Candelaria, Gabriela T. P. ^[1] ; Sakashita, Araci M. ^[2] ; Machado, Rafael Rahal Guaragna ^[4] ; Fontao-Wendel, Rita ^[1] ; Hamerschlak, Nelson ^[2] ; Achkar, Ruth ^[1] ; Assuncao, Murillo Santucci Cesar ^[2] ; Scuracchio, Patricia ^[1] ; Nudelman, Victor ^[2] ; Pastore, Laerte ^[5] ; Pinho, Joao R. R. ; Ben, Mirian Dal ^[5] ; Filho, Roberto Kalil ^{[6, 5]} ; Marra, Alexandre R. ^[7] ; Amano, Mariane T. ^[5] ; Kallas, Esper G. ^{[8, 5]} ; Helito, Alfredo Salim ^[5] ; de Carvalho, Carlos Roberto Ribeiro ^{[5, 9]} ; Araujo, Danielle Bastos ^[4] ; Durigon, Edison Luiz ^{[4, 10]} ; Camargo, Anamaria A. ^[5] ; Rizzo, Luiz V. ^[2] ; Reis, Luiz F. L. ^[5] ; Kutner, Jose M. ^[2]

Affiliation

^[1] Hosp Sirio Libanes Blood Bank, Sao Paulo - Brazil

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

^[3] Hosp Sirio Libanes, Brasilia, DF - Brazil

^[4] Univ Sao Paulo, Inst Biomed Sci, Dept Microbiol, Sao Paulo - Brazil

^[5] Hosp Sirio Libanes, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Heart Inst InCor, Sao Paulo - Brazil

^[7] Univ Iowa Hosp & Clin, Off Clin Qual Safety & Performance Improvement, Iowa City, IA 52242 - USA

^[8] Univ Sao Paulo, Sch Med, Dept Infect & Parasit Dis, Sao Paulo - Brazil

^[9] Univ Sao Paulo, Heart Inst Incor, Div Pulm, Cardiopulm Dept, Sao Paulo - Brazil

^[10] Sci Platform Pasteur USP, Sao Paulo - Brazil

• Document type: Journal article
• Source: Transfusion; v. 61, n. 8 JUL 2021.
• Web of Science Citations: 0

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. (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 Opportunities: Regular Research Grants
• 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 Opportunities: Research Projects - Thematic Grants