Convalescent plasma with a high level of virus-specific antibody effectively neutralizes SARS-CoV-2 variants of concern

M Li, EJ Beck, O Laeyendecker, Y Eby… - Blood …, 2022 - ashpublications.org
M Li, EJ Beck, O Laeyendecker, Y Eby, AAR Tobian, P Caturegli, C Wouters, GR Chiklis…
Blood advances, 2022ashpublications.org
The ongoing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
variants severely limits available effective monoclonal antibody therapies. Effective drugs
are also supply limited. COVID-19 convalescent plasma (CCP) qualified for high antibody
levels effectively reduces immunocompetent outpatient hospitalization. The Food and Drug
Administration currently allows outpatient CCP for the immunosuppressed. Viral-specific
antibody levels in CCP can range 10-to 100-fold between donors, unlike the uniform viral …
Abstract
The ongoing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants severely limits available effective monoclonal antibody therapies. Effective drugs are also supply limited. COVID-19 convalescent plasma (CCP) qualified for high antibody levels effectively reduces immunocompetent outpatient hospitalization. The Food and Drug Administration currently allows outpatient CCP for the immunosuppressed. Viral-specific antibody levels in CCP can range 10- to 100-fold between donors, unlike the uniform viral-specific monoclonal antibody dosing. Limited data are available on the efficacy of polyclonal CCP to neutralize variants. We examined 108 pre-δ/pre-ο donor units obtained before March 2021, 20 post-δ COVID-19/postvaccination units, and 1 pre-δ/pre-ο hyperimmunoglobulin preparation for variant-specific virus (vaccine-related isolate [WA-1], δ, and ο) neutralization correlated to Euroimmun S1 immunoglobulin G antibody levels. We observed a two- to fourfold and 20- to 40-fold drop in virus neutralization from SARS-CoV-2 WA-1 to δ or ο, respectively. CCP antibody levels in the upper 10% of the 108 donations as well as 100% of the post-δ COVID-19/postvaccination units and the hyperimmunoglobulin effectively neutralized all 3 variants. High-titer CCP neutralizes SARS-CoV-2 variants despite no previous donor exposure to the variants.
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