Individual patient and donor seroprofiles in convalescent plasma treatment of COVID-19 in REMAP-CAP clinical trial - 13/02/25
, Richard Mayne a, Chanice Knight a, Hannia L. Almonacid-Mendoza c, Shannah Secret a, c, Lise Estcourt c, d, Jussi Hepojoki b, e, Tonći Šuštić f, g, Abigail A. Lamikanra c, d, Hoi Pat Tsang c, David K. Menon h, Manu Shankar-Hari i, C. Ellen van der Schoot f, j, Gestur Vidarsson f, g, David J. Roberts c, d, Peter Simmonds a, Klaus Hedman b, k, Heli Harvala d, l, m
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Summary |
Objectives |
Convalescent plasma (CP) treatment of COVID-19 has shown significant therapeutic effect only when administered early. We investigated the importance of patient and CP seroprofiles on treatment outcome in REMAP-CAP CP trial.
Methods |
We evaluated neutralising antibodies (nAb), anti-spike (S) IgM, IgG, IgG avidity, IgG fucosylation and respiratory viral loads in a sub-set of patients (n=80) and controls (n=51) before and after transfusion, comparing them to those in the CP units (n=157) they received.
Results |
Most patients were SARS-CoV-2 seropositive pre-transfusion (72% nAb; 89% S-IgG seropositivity). The majority (80%) had higher pre-transfusion S-IgG levels (median 1.7×106 arbitrary units (AU); 56%) or S-IgG production rates (median 1.1×106 AU/day; 64%) than they received from CP (median 2.2×105 AU). Only 22% of the patients demonstrated significant (median 24-fold) increase in their S-IgG levels acquired from transfusion. Better outcomes, measured by organ support-free days, were associated with increase in S-IgM levels (p=0.007), decreased S-IgG fucosylation (p<0.001), lower patient age (p<0.001) but not with receiving CP (p=0.337).
Conclusions |
Based on our data, increased S-antibody levels linked to transfused CP were only observed in pre-seroconversion or immunodeficient patients lacking their own SARS-CoV-2 antibodies, representing the groups where CP treatment has previously shown most benefit.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Early convalescent plasma treatment of hospitalised COVID-19 patients is important. |
• | Seroprofiles of patients and transfused plasma were compared at individual level. |
• | Most patients, with primary SARS-CoV-2 infection, were seropositive pre-transfusion. |
• | Transfused antibody quantity was low compared to endogenous Ab and de novo production. |
• | Pre-seroconversion patients, or presently the immunodeficient, should be treated instead. |
Keywords : Infectious diseases, Transfusion medicine, Critical care, Virology, COVID-19, SARS-CoV-2, Convalescent plasma treatment, Serology, Antibodies
Plan
Vol 90 - N° 2
Article 106412- février 2025 Retour au numéro
Article précédent
- Safety and immunogenicity of Omicron protein vaccines in mRNA-vaccinated adolescents: A phase 3, randomised trial
- Chijioke Bennett, Gordon Chau, Erika Clayton, Laurence Chu, Jacqueline Alvarez, Ausberto B. Hidalgo, Khozema Palanpurwala, Joyce S. Plested, Mingzhu Zhu, Shane Cloney-Clark, Zhaohui Cai, Raj Kalkeri, Karim Hegazy, Katherine Smith, Susan Neal, Fernando Noriega, Raburn M. Mallory, Jeffrey M. Adelglass, on behalf of the 2019nCoV-314 Study Investigators
- Evaluation of the diagnostic accuracy of Xpert® Mpox and STANDARD™ M10 MPX/OPX for the detection of monkeypox virus
- Alessandra Romero-Ramirez, Anushri Somasundaran, Konstantina Kontogianni, Jacob Parkes, Yusra Hussain, Susan Gould, Christopher T. Williams, Dominic Wooding, Richard Body, Hayley E. Hardwick, J. Kenneth Baillie, Jake Dunning, Malcolm G. Semple, CONDOR steering group, ISARIC 4C Investigators, Tom E. Fletcher, Thomas Edwards, Devy Emperador, Ana I. Cubas-Atienzar
Bienvenue sur EM-consulte, la référence des professionnels de santé.