Abstract
The latest SARS-CoV-2 variant of concern Omicron, with its immune escape from therapeutic anti-Spike monoclonal antibodies and WA-1 vaccine-elicited sera, demonstrates the continued relevance of COVID-19 convalescent plasma (CCP) therapies. Lessons learnt from previous usage of CCP suggests focusing on early outpatients and immunocompromised recipients, with high neutralizing antibody titer units. Here, we systematically review Omicron-neutralizing plasma activity data, and report that approximately 47% (424/902) of CCP samples from unvaccinated pre-Omicron donors neutralizes Omicron BA.1 with a very low geometric mean of geometric mean titers for 50% neutralization GM(GMT 50 ) of ~13, representing a > 20-fold reduction from WA-1 neutralization. Non-convalescent subjects who had received two doses of mRNA vaccines had a GM(GMT50) for Omicron BA.1 neutralization of ~27. However, plasma from vaccinees recovering from either previous pre-Omicron variants of concern infection, Omicron BA.1 infection, or third-dose uninfected vaccinees was nearly 100% neutralizing against Omicron BA.1, BA.2 and BA.4/5 with GM(GMT( 50 )) all over 189, 10 times higher than pre-Omicron CCP. Fully vaccinated and post-BA.1 plasma (Vax-CCP) had a GM(GMT 50 ) > 450 for BA.4/5 and >1,500 for BA.1 and BA.2. These findings have implications for both CCP stocks collected in prior pandemic periods and for future plans to restart CCP collections. Thus, Vax-CCP provides an effective tool to combat ongoing variants that escape therapeutic monoclonal antibodies.
【초록키워드】 COVID-19, convalescent plasma, pandemic, mRNA vaccine, neutralization, monoclonal antibody, variant, SARS-CoV-2 variant, Infection, variants of concern, omicron, monoclonal antibodies, Immune escape, sera, therapeutic, Immunocompromised, plasma, Neutralizing, Therapies, Neutralizing antibody titer, Donor, Outpatient, dose, CCP, reduction, recipients, subject, lesson, geometric mean titer, uninfected, implication, effective, neutralize, vaccinee, collected, provide, representing, geometric, plasma activity, 【제목키워드】 convalescent plasma, anti-SARS-CoV-2, Antibody titer,