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

Arvind Gharbharan, Carlijn C. E. Jordans, Corine GeurtsvanKessel, Jan G. Hollander, Faiz Karim, Femke P. N. Mollema, Janneke E. Stalenhoef – Schukken, Anthonius Dofferhoff, Inge Ludwig, Adrianus Koster, Robert-Jan Hassing, Jeannet C. Bos, Geert R. Pottelberge, Imro N. Vlasveld, Heidi S. M. Ammerlaan, Elena M. Leeuwen – Segarceanu, Jelle Miedema, Menno Eerden, Thijs J. Schrama, Grigorios Papageorgiou, Peter Boekhorst, Francis H. Swaneveld, Yvonne M. Mueller, Marco W. J. Schreurs, Jeroen J. A. Kampen, Barry Rockx, Nisreen M. A. Okba, Peter D. Katsikis, Marion P. G. Koopmans, Bart L. Haagmans, Casper Rokx () and Bart J. A. Rijnders
Additional contact information
Arvind Gharbharan: University Medical Center
Carlijn C. E. Jordans: University Medical Center
Corine GeurtsvanKessel: University Medical Center
Jan G. Hollander: Maasstad Hospital
Faiz Karim: Groene Hart Hospital
Femke P. N. Mollema: Haaglanden Medical Center
Janneke E. Stalenhoef – Schukken: OLVG Hospital
Anthonius Dofferhoff: Canisius Wilhelmina Hospital
Inge Ludwig: Bernhoven Hospital
Adrianus Koster: Viecuri Medical Center
Robert-Jan Hassing: Rijnstate Hospital
Jeannet C. Bos: Reinier de Graaf Gasthuis
Geert R. Pottelberge: ZorgSaam Hospital
Imro N. Vlasveld: Martini Hospital
Heidi S. M. Ammerlaan: Catharina Hospital
Elena M. Leeuwen – Segarceanu: Sint Antonius Hospital
Jelle Miedema: University Medical Center
Menno Eerden: University Medical Center
Thijs J. Schrama: University Medical Center
Grigorios Papageorgiou: University Medical Center
Peter Boekhorst: University Medical Center
Francis H. Swaneveld: Unit of Transfusion Medicine, Sanquin Blood Supply
Yvonne M. Mueller: University Medical Center
Marco W. J. Schreurs: University Medical Center
Jeroen J. A. Kampen: University Medical Center
Barry Rockx: University Medical Center
Nisreen M. A. Okba: University Medical Center
Peter D. Katsikis: University Medical Center
Marion P. G. Koopmans: University Medical Center
Bart L. Haagmans: University Medical Center
Casper Rokx: University Medical Center
Bart J. A. Rijnders: University Medical Center

Nature Communications, 2021, vol. 12, issue 1, 1-12

Abstract: Abstract In 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.

Date: 2021
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DOI: 10.1038/s41467-021-23469-2

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