COVID-19 is an ongoing pandemic with high morbidity and mortality. Despite meticulous research, only dexamethasone has shown consistent mortality reduction. Convalescent plasma (CP) infusion might also develop into a safe and effective treatment modality on the basis of recent studies and meta-analyses; however, little is known regarding the kinetics of antibodies in CP recipients. To evaluate the kinetics, we followed 31 CP recipients longitudinally enrolled at a median of 3 days post symptom onset for changes in binding and neutralizing antibody titers and viral loads. Antibodies against the complete trimeric Spike protein and the receptor-binding domain (Spike-RBD), as well as against the complete Nucleocapsid protein and the RNA binding domain (N-RBD) were determined at baseline and weekly following CP infusion. Neutralizing antibody (pseudotype NAb) titers were determined at the same time points. Viral loads were determined semi-quantitatively by SARS-CoV-2 PCR. Patients with low humoral responses at entry showed a robust increase of antibodies to all SARS-CoV-2 proteins and Nab, reaching peak levels within 2 weeks. The rapid increase in binding and neutralizing antibodies was paralleled by a concomitant clearance of the virus within the same timeframe. Patients with high humoral responses at entry demonstrated low or no further increases; however, virus clearance followed the same trajectory as in patients with low antibody response at baseline. Together, the sequential immunological and virological analysis of this well-defined cohort of patients early in infection shows the presence of high levels of binding and neutralizing antibodies and potent clearance of the virus.
【저자키워드】 COVID-19, convalescent plasma, SARS-CoV-2, Neutralizing antibodies, spike, nucleocapsid, antibody kinetics, 【초록키워드】 Dexamethasone, Treatment, neutralizing antibody, pandemic, Mortality, Neutralizing antibodies, antibody, Antibody Response, Infection, virus, Spike protein, nucleocapsid protein, RNA, Protein, Kinetics, Viral, Receptor-binding domain, Humoral response, pseudotype, Research, Patient, trajectory, plasma, Trimeric spike protein, morbidity and mortality, Antibody titers, Neutralizing antibody titer, binding, Analysis, meta-analyses, SARS-CoV-2 proteins, SARS-CoV-2 PCR, titers, Safe, peak levels, reduction, symptom onset, Virological, recipients, virus clearance, neutralizing antibody titers, viral loads, rapid increase, binding domain, SARS-CoV-2 protein, recipient, CP infusion, binding and neutralizing antibodies, clearance, Complete, immunological, effective, trimeric, robust, enrolled, shown, develop, evaluate, median, changes in, demonstrated, the receptor-binding domain, baseline, cohort of patient, kinetics of antibody, 【제목키워드】 load,