SARS-CoV-2 serology and virology trends in donors and recipients of convalescent plasma

Latha Dulipsingh, Danyal Ibrahim, Ernst J Schaefer, Rebecca Crowell, Margaret R Diffenderfer, Kendra Williams, Colleen Lima, Jessica McKenzie, Lisa Cook, Jennifer Puff, Mary Onoroski, Dorothy B Wakefield, Reginald J Eadie, Steven B Kleiboeker, Patricia Nabors, Syed A Hussain, Latha Dulipsingh, Danyal Ibrahim, Ernst J Schaefer, Rebecca Crowell, Margaret R Diffenderfer, Kendra Williams, Colleen Lima, Jessica McKenzie, Lisa Cook, Jennifer Puff, Mary Onoroski, Dorothy B Wakefield, Reginald J Eadie, Steven B Kleiboeker, Patricia Nabors, Syed A Hussain

Abstract

SARS-CoV-2 has infected millions worldwide. The virus is novel, and currently there is no approved treatment. Convalescent plasma may offer a treatment option. We evaluated trends of IgM/IgG antibodies/plasma viral load in donors and recipients of convalescent plasma. 114/139 (82 %) donors had positive IgG antibodies. 46/114 donors tested positive a second time by NP swab. Among those retested, the median IgG declined (p < 0.01) between tests. 25/139 donors with confirmed SARS-CoV-2 were negative for IgG antibodies. This suggests that having had the infection does not necessarily convey immunity, or there is a short duration of immunity associated with a decline in antibodies. Plasma viral load obtained on 35/39 plasma recipients showed 22 (62.9 %) had non-detectable levels on average 14.5 days from positive test versus 6.2 days in those with detectable levels (p < 0.01). There was a relationship between IgG and viral load. IgG was higher in those with non-detectable viral loads. There was no relationship between viral load and blood type (p = 0.87) or death (0.80). Recipients with detectable viral load had lower IgG levels; there was no relationship between viral load, blood type or death.

Keywords: Adults; Antigens; Blood transfusion; COVID-19; COVID-19 serotherapy; Coronavirus; Coronavirus infections; Humans; Immunoglobulin G; Immunoglobulin M; Plasma; SARS virus; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Viral; Viral load.

Conflict of interest statement

The authors declare that they have no competing interests.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
IgG change in donors re-tested.
Fig. 2
Fig. 2
7 day change in IgG in recipients of convalescent plasma.

References

    1. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 66. . 2020 March 26 (cited 2020 15 June).
    1. Johns Hopkins University and Medicine. Coronavirus resource center. COVID-19 global cases (cited 2020 Aug 6). .
    1. Barlow A., Landolf K.M., Barlow B., Yeung S.Y.A., Heavner J.J., Claassen C.W. Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019. Pharmacotherapy. 2020;40(5):416–437. doi: 10.1002/phar.2398.
    1. US Food and Drug Administration . 2020. Investigational COVID-19 convalescent plasma: emergency INDs. (accessed 2020 March 30; guidance updated 2020 May 1)
    1. Zhou B., Zhong N., Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection. N Engl J Med. 2007;357(14):1450–1451. doi: 10.1056/NEJMc070359.
    1. Hung I.F., To K.K., Lee C.K., Lee K.L., Chan K., Yan W.W. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis. 2011;52(4):447–456. doi: 10.1093/cid/ciq106.
    1. Burnouf T., Radosevich M. Treatment of severe acute respiratory syndrome with convalescent plasma. Hong Kong Med J. 2003;9(4):309. ; author reply 10.
    1. Cheng Y., Wong R., Soo Y.O., Wong W.S., Lee C.K., Ng M.H. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44–46. doi: 10.1007/s10096-004-1271-9.
    1. Mair-Jenkins J., Saavedra-Campos M., Baillie J.K., Cleary P., Khaw F.M., Lim W.S. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis. 2015;211(1):80–90. doi: 10.1093/infdis/jiu396.
    1. Sun M., Xu Y., He H., Zhang L., Wang X., Qiu Q. Potential effective treatment for COVID-19: systematic review and meta-analysis of the severe infectious disease with convalescent plasma therapy. Int J Infect Dis. 2020 doi: 10.1016/j.ijid.2020.06.107. (cited 2020 July 30). Epub 2020 July4.
    1. Li L., Tong X., Chen H., He R., Lv Q., Yang R. Characteristics and serological patterns of COVID-19 convalescent plasma donors: optimal donors and timing of donation. Transfusion. 2020;(July (6)) 10.1111/trf.15918. doi: 10.1111/trf.15918. Epub ahead of print. (cited 2020 July 30)
    1. Long Q.X., Tang X.J., Shi Q.L. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med. 2020;26(August (8)):1200–1204. doi: 10.1038/s41591-020-0965-6. Epub 2020 Jun 18.
    1. Shen C., Wang Z., Zhao F. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. 2020;323(16):1582–1589. doi: 10.1001/jama.2020.4783. [published online ahead of print, 2020 Mar 27]
    1. Psaltopoulou T., Sergentanis T.N., Pappa V., Politou M., Terpos E., Tsiodras S. The emerging role of convalescent plasma in the treatment of COVID-19. Hemasphere. 2020;4(3):e409. doi: 10.1097/HS9.0000000000000409. Published 2020 May 21.
    1. Zhang B., Liu S., Tan T. Treatment with convalescent plasma for critically ill patients with severe acute respiratory syndrome coronavirus 2 infection. Chest. 2020;158(1):e9–e13. doi: 10.1016/j.chest.2020.03.039.
    1. Duan K., Liu B., Li C. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. 2020;117(17):9490–9496. doi: 10.1073/pnas.2004168117.
    1. Ye M., Fu D., Ren Y., Wang F., Wang D., Zhang F. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol. 2020 doi: 10.1002/jmv.25882. (cited 2020 June 15) Epub 2020 April 15.
    1. Zhang L., Pang R., Xue X., Bao J., Ye S., Dai Y. Anti-SARS-CoV-2 virus antibody levels in convalescent plasma of six donors who have recovered from COVID-19. Aging (Albany NY). 2020;12(8):6536–6542. doi: 10.18632/aging.103102.
    1. Ahn J.Y., Sohn Y., Lee S.H. Use of convalescent plasma therapy in two COVID-19 patients with acute respiratory distress syndrome in Korea. J Korean Med Sci. 2020;35(14):e149. doi: 10.3346/jkms.2020.35.e149. Published 2020 Apr 13.
    1. Yan R., Zhang Y., Li Y., Xia L., Guo Y., Zhou Q. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science. 2020;367(6485):1444–1448. doi: 10.1126/science.abb2762. (cited 2020 June 15). Epub 2020/03/04.
    1. Ou X., Liu Y., Lei X., Li P., Mi D., Ren L. Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nat Commun. 2020;11(1):1620. doi: 10.1038/s41467-020-15562-9. (cited 2020 July 30). Epub 2020 March 27.
    1. Casadevall A., Pirofski L.A. The convalescent sera option for containing COVID-19. J Clin Invest. 2020;130(4):1545–1548. doi: 10.1172/JCI138003. Apr 1.
    1. Tiberghien P., de Lamballerie X., Morel P., Gallian P., Lacombe K., Yazdanpanah Y. Collecting and evaluating convalescent plasma for COVID-19 treatment: why and how? Vox Sang. 2020 10.1111/vox.12926. doi:10.1111/vox.12926 (cited 2020 June 6) Epub 2020/04/02.
    1. To K.K., Tsang O.T., Leung W.S., Tam A.R., Wu T.C., Lung D.C. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565–574. doi: 10.1016/S1473-3099(20)30196-1.
    1. Zhong L., Chuan J., Gong B.O., Shuai P., Zhou Y., Zhang Y. Detection of serum IgM and IgG for COVID-19 diagnosis. Sci China Life Sci. 2020;63(May 5):777–780. doi: 10.1007/s11427-020-1688-9.
    1. Korean Centers for Disease Control (press release) Findings from investigation and analysis of re-positive cases; 2020 May 21 (cited 2020 June 6). .
    1. Zietz M., Tatonetti N.P. Testing the association between blood type and COVID-19 infection, intubation, and death. medRxiv. 2020 [Preprint]. 2020 Apr 11:2020.04.08.20058073. doi: 10.1101/2020.04.08.20058073. (cited 2020 June 20)
    1. Yu F., Yan L., Wang N., Yang S., Wang L., Tang Y. Quantitative detection and viral load analysis of SARS-CoV-2 in infected patients. Clin Infect Dis. 2020;71(15):793–798. doi: 10.1093/cid/ciaa345.
    1. Zheng S., Fan J., Yu F., Feng B., Lou B., Zou Q. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ Epub. 2020;21(April (369)):m1443. doi: 10.1136/bmj.m1443. (cited 2020 June 16)
    1. Wölfel R., Corman V.M., Guggemos W., Seilmaier M., Zange S. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(May 7809):465–469. doi: 10.1038/s41586-020-2196-x.
    1. Chen X., Zhao B., Qu Y., Chen Y., Xiong J., Feng Y. Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely correlated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients. Clin Infect Dis. 2020;(April (17)):ciaa449. doi: 10.1093/cid/ciaa449. (cited 2020 June 16) Epub ahead of print.
    1. Lescure F.X., Bouadma L., Nguyen D., Parisey M., Wicky P.H., Behillil S. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet Infect Dis. 2020;20(6):697–706. doi: 10.1016/S1473-3099(20). [published correction appears in Lancet Infect Dis. 2020 May 19;:] [published correction appears in Lancet Infect Dis. 2020 Jun;20(6):e116]

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa