February 18, 2022
1 min read
Source/Disclosures
sources:
Abela IA. High neutralizing convalescent plasma results in rapid clearance of SARS-CoV-2. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 12-16, 2022 (virtual meeting).
Disclosures:
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Convalescent plasma with high neutralizing antibodies produced a strong and rapid viral clearance when administered to patients hospitalized with COVID-19, according to recent data.
“We also saw that patients who already had neutralizing antibodies before treatment also benefited from convalescent plasma therapy (CPT) with high neutralizing titers,” Irene A AbelaMD, PhD, an infectious disease physician and scientist in medical virology at the University of Zurich in Switzerland, said during a presentation at the Conference on Retroviruses and Opportunistic Infections. “I think this really has an impact on the broader time of treatment and when you should treat patients with antivirals.”
Abela IA. High neutralizing convalescent plasma results in rapid clearance of SARS-CoV-2. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 12-16, 2022 (virtual meeting).
Abela and colleagues conducted a proof-of-principle study of CPT in 2020. The cohort included 30 patients in Zurich who were hospitalized with COVID-19, with a median interval of 9 days between symptom onset and the first transfusion of plasma. Participants received three donations of plasma on 3 consecutive days. Following the transfusions, the researchers assessed participants for laboratory parameters, recession response and viremia through nasopharyngeal swabs. They also considered the viral load present in the CPT transfusions.
Overall, CPT resulted in no transfusion-related adverse events, according to the researchers.
Abela and colleagues reported a 3.3% mortality rate among participants. Treatment with highly neutralizing plasma was significantly associated with faster virus clearance (P = .034).
The researchers observed a strong effect of endogenous immunity on virus control. At baseline, a lack of endogenous neutralizing activity was associated with a higher risk for systemic viremia. The onset of endogenous neutralization had an effect on viral clearance; however, even after adjusting for endogenous neutralization status, recipients benefited from plasma therapy with high neutralizing antibodies (HR= 4; 95% CI, 1.3-13).
An absence of neutralization antibodies before treatment was linked to the presence of plasma viremia, particularly with higher viral loads, Abela said. Rising neutralizing response in recipients had a strong impact on viral clearance, she added.
While this study was conducted early in the pandemic when other treatments were not available, more recent trials and meta-analyses have not shown the impact plasma may have on hospitalization, according to Abela.
“Plasma viremia should be explored as a clinical parameter for all individuals who lack sufficient neutralizing activity,” she said.
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