Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibody Titers in Convalescent Plasma and Recipients in New Mexico: An Open Treatment Study in Patients With Coronavirus Disease 2019

Authors

Steven B. Bradfute, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Ivy Hurwitz, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Alexandra V. Yingling, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Chunyan Ye, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Qiuying Cheng, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Timothy P Noonan, Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Jay S. Raval, Department of Pathology, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Nestor R. Sosa, Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Gregory J. Mertz, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Douglas J. Perkins, Center for Global Health, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Michelle S. Harkins, Division of Pulmonary, Critical Care and Sleep, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA

Document Type

Article

Publication Date

10-13-2020

Abstract

BACKGROUND: Convalescent plasma (CP) is a potentially important therapy for coronavirus disease 2019 (COVID-19). However, knowledge regarding neutralizing antibody (NAb) titers in donor plasma and their impact in patients with acute COVID-19 remains largely undetermined. We measured NAb titers in CP and in patients with acute COVID-19 before and after transfusion through the traditional Food and Drug Administration investigational new drug pathway.

METHODS: We performed a single-arm interventional trial measuring NAb and total antibody titers before and after CP transfusion over a 14-day period in hospitalized patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection.

RESULTS: NAb titers in the donor CP units were low (1:160) and had no effect on recipient neutralizing activity 1 day after transfusion. NAb titers were detected in 6 of 12 patients on enrollment and in 11 of 12 at ≥2 time points. Average titers peaked on day 7 and declined toward day 14 (P = .004). Nab titers and immunoglobulin G levels were correlated in donor plasma units (ρ = 0.938; P < .001) and in the cumulative patient measures (ρ = 0.781; P < .001).

CONCLUSIONS: CP infusion did not alter recipient NAb titers. Prescreening of CP may be necessary for selecting donors with high titers of neutralizing activity for infusion into patients with COVID-19.

CLINICAL TRIALS REGISTRATION: NCT04434131.

Recommended Citation

Bradfute SB, Hurwitz I, Yingling AV, Ye C, Cheng Q, Noonan TP, Raval JS, Sosa NR, Mertz GJ, Perkins DJ, Harkins MS. Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibody Titers in Convalescent Plasma and Recipients in New Mexico: An Open Treatment Study in Patients With Coronavirus Disease 2019. J Infect Dis. 2020 Oct 13;222(10):1620-1628. doi: 10.1093/infdis/jiaa505. PMID: 32779705; PMCID: PMC7454720.