tetano
Editor, Senior Moderator
Am J Pathol
. 2020 Nov 3;S0002-9440(20)30489-2.
doi: 10.1016/j.ajpath.2020.10.008. Online ahead of print.
Significantly decreased mortality in a large cohort of COVID-19 patients transfused early with convalescent plasma containing high titer anti-SARS-CoV-2 spike protein IgG
Eric Salazar[SUP] 1 [/SUP], Paul A Christensen[SUP] 2 [/SUP], Edward A Graviss[SUP] 3 [/SUP], Duc T Nguyen[SUP] 4 [/SUP], Brian Castillo[SUP] 2 [/SUP], Jian Chen[SUP] 2 [/SUP], Bevin Valdez Lopez[SUP] 5 [/SUP], Todd N Eagar[SUP] 1 [/SUP], Xin Yi[SUP] 1 [/SUP], Picheng Zhao[SUP] 2 [/SUP], John Rogers[SUP] 2 [/SUP], Ahmed Shehabeldin[SUP] 2 [/SUP], David Joseph[SUP] 2 [/SUP], Faisal Masud[SUP] 6 [/SUP], Christopher Leveque[SUP] 2 [/SUP], Randall J Olsen[SUP] 7 [/SUP], David W Bernard[SUP] 1 [/SUP], Jimmy Gollihar[SUP] 8 [/SUP], James M Musser[SUP] 9 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) convalescent plasma has emerged as a promising therapy and has been granted emergency use authorization by the U.S. Food and Drug Administration (FDA) for hospitalized COVID-19 patients. We recently reported results from interim analysis of a propensity-score matched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing high titer anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. We here present results from 60-day follow up of our cohort of 351 transfused hospitalized patients. Prospective determination of ELISA anti-RBD IgG titer facilitated selection and transfusion of the highest titer units available. Retrospective analysis by the Ortho VITROS IgG assay revealed a median signal/cutoff (S/C) ratio of 24.0 for transfused units, a value far exceeding the recently FDA-required cutoff of 12.0 for designation of high titer convalescent plasma. With respect to altering mortality, our analysis identified an optimal window of 44 hours post-hospitalization for transfusing COVID-19 patients with high titer convalescent plasma. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality.
. 2020 Nov 3;S0002-9440(20)30489-2.
doi: 10.1016/j.ajpath.2020.10.008. Online ahead of print.
Significantly decreased mortality in a large cohort of COVID-19 patients transfused early with convalescent plasma containing high titer anti-SARS-CoV-2 spike protein IgG
Eric Salazar[SUP] 1 [/SUP], Paul A Christensen[SUP] 2 [/SUP], Edward A Graviss[SUP] 3 [/SUP], Duc T Nguyen[SUP] 4 [/SUP], Brian Castillo[SUP] 2 [/SUP], Jian Chen[SUP] 2 [/SUP], Bevin Valdez Lopez[SUP] 5 [/SUP], Todd N Eagar[SUP] 1 [/SUP], Xin Yi[SUP] 1 [/SUP], Picheng Zhao[SUP] 2 [/SUP], John Rogers[SUP] 2 [/SUP], Ahmed Shehabeldin[SUP] 2 [/SUP], David Joseph[SUP] 2 [/SUP], Faisal Masud[SUP] 6 [/SUP], Christopher Leveque[SUP] 2 [/SUP], Randall J Olsen[SUP] 7 [/SUP], David W Bernard[SUP] 1 [/SUP], Jimmy Gollihar[SUP] 8 [/SUP], James M Musser[SUP] 9 [/SUP]
Affiliations
- PMID: 33157066
- DOI: 10.1016/j.ajpath.2020.10.008
Abstract
Coronavirus disease 2019 (COVID-19) convalescent plasma has emerged as a promising therapy and has been granted emergency use authorization by the U.S. Food and Drug Administration (FDA) for hospitalized COVID-19 patients. We recently reported results from interim analysis of a propensity-score matched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing high titer anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. We here present results from 60-day follow up of our cohort of 351 transfused hospitalized patients. Prospective determination of ELISA anti-RBD IgG titer facilitated selection and transfusion of the highest titer units available. Retrospective analysis by the Ortho VITROS IgG assay revealed a median signal/cutoff (S/C) ratio of 24.0 for transfused units, a value far exceeding the recently FDA-required cutoff of 12.0 for designation of high titer convalescent plasma. With respect to altering mortality, our analysis identified an optimal window of 44 hours post-hospitalization for transfusing COVID-19 patients with high titer convalescent plasma. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality.