Dataset Information

Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19.

ABSTRACT:

Background

Convalescent plasma has been widely used to treat coronavirus disease 2019 (Covid-19) under the presumption that such plasma contains potentially therapeutic antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can be passively transferred to the plasma recipient. Whether convalescent plasma with high antibody levels rather than low antibody levels is associated with a lower risk of death is unknown.

Methods

In a retrospective study based on a U.S. national registry, we determined the anti-SARS-CoV-2 IgG antibody levels in convalescent plasma used to treat hospitalized adults with Covid-19. The primary outcome was death within 30 days after plasma transfusion. Patients who were enrolled through July 4, 2020, and for whom data on anti-SARS-CoV-2 antibody levels in plasma transfusions and on 30-day mortality were available were included in the analysis.

Results

Of the 3082 patients included in this analysis, death within 30 days after plasma transfusion occurred in 115 of 515 patients (22.3%) in the high-titer group, 549 of 2006 patients (27.4%) in the medium-titer group, and 166 of 561 patients (29.6%) in the low-titer group. The association of anti-SARS-CoV-2 antibody levels with the risk of death from Covid-19 was moderated by mechanical ventilation status. A lower risk of death within 30 days in the high-titer group than in the low-titer group was observed among patients who had not received mechanical ventilation before transfusion (relative risk, 0.66; 95% confidence interval [CI], 0.48 to 0.91), and no effect on the risk of death was observed among patients who had received mechanical ventilation (relative risk, 1.02; 95% CI, 0.78 to 1.32).

Conclusions

Among patients hospitalized with Covid-19 who were not receiving mechanical ventilation, transfusion of plasma with higher anti-SARS-CoV-2 IgG antibody levels was associated with a lower risk of death than transfusion of plasma with lower antibody levels. (Funded by the Department of Health and Human Services and others; ClinicalTrials.gov number, NCT04338360.).

SUBMITTER: Joyner MJ

PROVIDER: S-EPMC7821984 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19.

Joyner Michael J MJ Carter Rickey E RE Senefeld Jonathon W JW Klassen Stephen A SA Mills John R JR Johnson Patrick W PW Theel Elitza S ES Wiggins Chad C CC Bruno Katelyn A KA Klompas Allan M AM Lesser Elizabeth R ER Kunze Katie L KL Sexton Matthew A MA Diaz Soto Juan C JC Baker Sarah E SE Shepherd John R A JRA van Helmond Noud N Verdun Nicole C NC Marks Peter P van Buskirk Camille M CM Winters Jeffrey L JL Stubbs James R JR Rea Robert F RF Hodge David O DO Herasevich Vitaly V Whelan Emily R ER Clayburn Andrew J AJ Larson Kathryn F KF Ripoll Juan G JG Andersen Kylie J KJ Buras Matthew R MR Vogt Matthew N P MNP Dennis Joshua J JJ Regimbal Riley J RJ Bauer Philippe R PR Blair Janis E JE Paneth Nigel S NS Fairweather DeLisa D Wright R Scott RS Casadevall Arturo A

The New England journal of medicine 20210113 11

<h4>Background</h4>Convalescent plasma has been widely used to treat coronavirus disease 2019 (Covid-19) under the presumption that such plasma contains potentially therapeutic antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can be passively transferred to the plasma recipient. Whether convalescent plasma with high antibody levels rather than low antibody levels is associated with a lower risk of death is unknown.<h4>Methods</h4>In a retrospective study based on a ...[more]

PMID: 33523609

Similar Datasets

Project description:BackgroundEarly administration of convalescent plasma obtained from blood donors who have recovered from coronavirus disease 2019 (Covid-19) may prevent disease progression in acutely ill, high-risk patients with Covid-19.MethodsIn this randomized, multicenter, single-blind trial, we assigned patients who were being treated in an emergency department for Covid-19 symptoms to receive either one unit of convalescent plasma with a high titer of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or placebo. All the patients were either 50 years of age or older or had one or more risk factors for disease progression. In addition, all the patients presented to the emergency department within 7 days after symptom onset and were in stable condition for outpatient management. The primary outcome was disease progression within 15 days after randomization, which was a composite of hospital admission for any reason, seeking emergency or urgent care, or death without hospitalization. Secondary outcomes included the worst severity of illness on an 8-category ordinal scale, hospital-free days within 30 days after randomization, and death from any cause.ResultsA total of 511 patients were enrolled in the trial (257 in the convalescent-plasma group and 254 in the placebo group). The median age of the patients was 54 years; the median symptom duration was 4 days. In the donor plasma samples, the median titer of SARS-CoV-2 neutralizing antibodies was 1:641. Disease progression occurred in 77 patients (30.0%) in the convalescent-plasma group and in 81 patients (31.9%) in the placebo group (risk difference, 1.9 percentage points; 95% credible interval, -6.0 to 9.8; posterior probability of superiority of convalescent plasma, 0.68). Five patients in the plasma group and 1 patient in the placebo group died. Outcomes regarding worst illness severity and hospital-free days were similar in the two groups.ConclusionsThe administration of Covid-19 convalescent plasma to high-risk outpatients within 1 week after the onset of symptoms of Covid-19 did not prevent disease progression. (SIREN-C3PO ClinicalTrials.gov number, NCT04355767.).

Dataset Information

Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19.

Background

Methods

Results

Conclusions

Publications

Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19.

Similar Datasets

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