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.
Keywords: COVID-19; antibodies; blood transfusion.
【저자키워드】 COVID-19, antibodies, Blood Transfusion, 【초록키워드】 Treatment, convalescent plasma, SARS-CoV-2, IgG, SARS-CoV2, vaccination, pandemic, intensive care, antibody, hospital, severe respiratory failure, ELISA, clinical outcomes, ICU, Clinical outcome, extracorporeal membrane oxygenation, Kinetics, survival, SARS-CoV-2 antibody, RBD, Patient, ECMO, plasma, patients, seropositive, seronegative, Blood, Antibody titre, anti-RBD, IgG and IgM, CCP, Support, LOS, Primary outcome, ventilator, individual, secondary outcome, ventilatory, titre, binding domain, recipient, while, blood draw, controls, IMPROVE, indicated, median, increase, were measured, anti-RBD IgM, control patient, patients with COVID-19, the SARS-CoV-2, with COVID-19, 【제목키워드】 convalescent plasma, Kinetics, Patient, case-control study, SARS-CoV-2 antibody response,