Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that immunological differences may impact the effectiveness of antibody-based treatments such as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma likely reflects the antigenic composition of local viral strains, we hypothesize that convalescent plasma has a higher efficacy, as defined by death within 30 days of transfusion, when the convalescent plasma donor and treated patient were in close geographic proximity. Results of a series of modeling techniques applied to approximately 28,000 patients from the Expanded Access to Convalescent Plasma program (ClinicalTrials.gov number: NCT04338360) support this hypothesis. This work has implications for the interpretation of clinical studies, the ability to develop effective COVID-19 treatments, and, potentially, for the effectiveness of COVID-19 vaccines as additional locally-evolving variants continue to emerge. Regional differences in SARS-CoV-2 variants may affect treatment outcome. Here, the authors show that near-sourced convalescent plasma has higher efficacy, as defined by death within 30 days of transfusion, than plasma sourced more than 150 miles away.
【저자키워드】 SARS-CoV-2, viral infection, Immunotherapy, 【초록키워드】 COVID-19, Treatment, coronavirus disease, convalescent plasma, Coronavirus disease 2019, Efficacy, Vaccine, coronavirus, Treatment outcome, COVID-19 vaccine, immune response, Vaccines, variant, SARS-CoV-2 variant, Local, severe acute respiratory syndrome Coronavirus, COVID-19 treatments, Expanded access, COVID-19 vaccines, SARS-CoV-2 variants, Patient, Interpretation, Effectiveness, death, access, Clinical studies, plasma, transfusion, respiratory, Donor, Hypothesis, viral strains, Support, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, antigenic, Regional, Affect, implication, immunological, effective, Result, defined, develop, applied, treated, reflect, 【제목키워드】 Donor, individual, treated, with COVID-19,