Abstract
COVID-19 convalescent plasma (CCP) has been the only specific anti-viral therapy against SARS-CoV-2 available for more than one year. Following the negative results from most randomized controlled trials on its efficacy in COVID-19 hospitalized patients and the availability of anti-spike monoclonal antibodies (mAbs), the use of CCP has subsequently rapidly faded. However, the continuous appearance of new variants of concern (VOCs), most of which escape mAbs and vaccine-elicited neutralizing antibodies (nAbs), has renewed the interest towards CCP, at least in seronegative immunocompetent patients, and in immunocompromised patients not able to mount a protective immune response. We report here the experience of a single Italian hospital in collecting and transfusing CCP in immunocompromised patients hospitalized for severe COVID-19 between October 2021 and March 2022. During this 6-month period, we collected CCP from 32 vaccinated and convalescent regular blood donors, and infused high nAb-titer CCP units (titered against the specific VOC affecting the recipient) to 21 hospitalized patients with severe COVID-19, all of them seronegative at the time of CCP transfusion. Patients’ median age was 66 years (IQR 50-74 years) and approximately half of them (47.6%, 10/21) were immunocompromised. Two patients were rescued after previous failure of mAbs. No adverse reactions following CCP transfusion were recorded. A 28-day mortality rate of 14.3 percent (3/21) was reported, with age, advanced disease stage and late CCP transfusion associated with a worse outcome. This real-life experience also supports the use of CCP in seronegative hospitalized COVID-19 patients during the Delta and Omicron waves.
Keywords: COVID-19 convalescent plasma; SARS-CoV-2; efficacy; variants of concern.
【저자키워드】 SARS-CoV-2, Efficacy, COVID-19 convalescent plasma, variants of concern., 【초록키워드】 COVID-19, Randomized controlled trial, convalescent plasma, neutralizing antibody, Hospitalized, severe COVID-19, Neutralizing antibodies, VoC, hospital, 28-day mortality, variants of concern, Immunocompromised patients, Delta, outcome, omicron, variants, Immunocompromised patient, Adverse reactions, Blood donors, VOCs, Immunocompromised, age, mortality rate, convalescent, Anti-viral therapy, patients, seronegative, COVID-19 convalescent plasma, mAbs, mAb, hospitalized COVID-19 patient, Adverse reaction, anti-spike monoclonal antibody, CCP, Support, median age, NAbs, protective immune response, two patients, recipient, anti-spike monoclonal antibodies, advanced disease, Italian, collected, reported, Two patient, hospitalized patient, affecting, rescued, were recorded, infused, IQR, 【제목키워드】 COVID-19, Usage,