Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection

• DOI: 10.1038/s41467-021-23469-2
• Publication Date: 2021-05-27T10:12:23Z
• Authors: Arvind Gharbharan; Carlijn C. E. Jor...; Corine GeurtsvanK...; Jan G. den Hollander; Faiz Karim; Femke P. N. Mollema; Janneke E. Stalen...; Anthonius Dofferhoff; Inge Ludwig; Adrianus Koster; Robert-Jan Hassing; Jeannet C. Bos; Geert R. van Pott...; Imro N. Vlasveld; Heidi S. M. Ammer...; Elena M. van Leeu...; Jelle Miedema; Menno van der Eerden; Thijs J. Schrama; Grigorios Papageo...; Peter te Boekhorst; Francis H. Swaneveld; Yvonne M. Mueller; Marco W. J. Schreurs; Jeroen J. A. van ...; Barry Rockx; Nisreen M. A. Okba; Peter D. Katsikis; Marion P. G. Koop...; Bart L. Haagmans; Casper Rokx; Bart J. A. Rijnders
• Keywords: Male; Science; Blood Donors; Kaplan-Meier Estimate; Antibodies, Viral; Article; 03 medical and health sciences; 0302 clinical medicine; Humans; COVID-19 Serotherapy; Aged; SARS-CoV-2; Q; Immunization, Passive; COVID-19; Middle Aged; Antibodies, Neutralizing; 3. Good health; Hospitalization; Treatment Outcome; Immunoglobulin G; Spike Glycoprotein, Coronavirus; Disease Progression; Cytokines; Female

AbstractIn a randomized clinical trial of 86 hospitalized COVID-19 patients comparing standard care to treatment with 300mL convalescent plasma containing high titers of neutralizing SARS-CoV-2 antibodies, no overall clinical benefit was observed. Using a comprehensive translational approach, we unravel the virological and immunological responses following treatment to disentangle which COVID-19 patients may benefit and should be the focus of future studies. Convalescent plasma is safe, does not improve survival, has no effect on the disease course, nor does plasma enhance viral clearance in the respiratory tract, influence SARS-CoV-2 antibody development or serum proinflammatory cytokines levels. Here, we show that the vast majority of patients already had potent neutralizing SARS-CoV-2 antibodies at hospital admission and with comparable titers to carefully selected plasma donors. This resulted in the decision to terminate the trial prematurely. Treatment with convalescent plasma should be studied early in the disease course or at least preceding autologous humoral response development.