Mortality in individuals treated with COVID-19 convalescent plasma varies with the geographic provenance of donors

Katie L. Kunze, Patrick W. Johnson, Noud Helmond, Jonathon W. Senefeld, Molly M. Petersen, Stephen A. Klassen, Chad C. Wiggins, Allan M. Klompas, Katelyn A. Bruno, John R. Mills, Elitza S. Theel, Matthew R. Buras, Michael A. Golafshar, Matthew A. Sexton, Juan C. Diaz Soto, Sarah E. Baker, John R. A. Shepherd, Nicole C. Verdun, Peter Marks, Nigel S. Paneth, DeLisa Fairweather, R. Scott Wright, Camille M. Buskirk, Jeffrey L. Winters, James R. Stubbs, Katherine A. Senese, Michaela C. Pletsch, Zachary A. Buchholtz, Robert F. Rea, Vitaly Herasevich, Emily R. Whelan, Andrew J. Clayburn, Kathryn F. Larson, Juan G. Ripoll, Kylie J. Andersen, Elizabeth R. Lesser, Matthew N. P. Vogt, Joshua J. Dennis, Riley J. Regimbal, Philippe R. Bauer, Janis E. Blair, Arturo Casadevall, Rickey E. Carter and Michael J. Joyner ()
Additional contact information
Katie L. Kunze: Mayo Clinic
Patrick W. Johnson: Mayo Clinic
Noud Helmond: Cooper University Health Care
Jonathon W. Senefeld: Mayo Clinic
Molly M. Petersen: Mayo Clinic
Stephen A. Klassen: Mayo Clinic
Chad C. Wiggins: Mayo Clinic
Allan M. Klompas: Mayo Clinic
Katelyn A. Bruno: Mayo Clinic
John R. Mills: Mayo Clinic
Elitza S. Theel: Mayo Clinic
Matthew R. Buras: Mayo Clinic
Michael A. Golafshar: Mayo Clinic
Matthew A. Sexton: Mayo Clinic
Juan C. Diaz Soto: Mayo Clinic
Sarah E. Baker: Mayo Clinic
John R. A. Shepherd: Mayo Clinic
Nicole C. Verdun: U.S. Food and Drug Administration
Peter Marks: U.S. Food and Drug Administration
Nigel S. Paneth: Michigan State University
DeLisa Fairweather: Mayo Clinic
R. Scott Wright: Mayo Clinic
Camille M. Buskirk: Mayo Clinic
Jeffrey L. Winters: Mayo Clinic
James R. Stubbs: Mayo Clinic
Katherine A. Senese: Mayo Clinic
Michaela C. Pletsch: Mayo Clinic
Zachary A. Buchholtz: Mayo Clinic
Robert F. Rea: Mayo Clinic
Vitaly Herasevich: Mayo Clinic
Emily R. Whelan: Mayo Clinic
Andrew J. Clayburn: Mayo Clinic
Kathryn F. Larson: Mayo Clinic
Juan G. Ripoll: Mayo Clinic
Kylie J. Andersen: Mayo Clinic
Elizabeth R. Lesser: Mayo Clinic
Matthew N. P. Vogt: Mayo Clinic
Joshua J. Dennis: Mayo Clinic
Riley J. Regimbal: Mayo Clinic
Philippe R. Bauer: Mayo Clinic
Janis E. Blair: Mayo Clinic
Arturo Casadevall: Johns Hopkins Bloomberg School of Public Health
Rickey E. Carter: Mayo Clinic
Michael J. Joyner: Mayo Clinic

Nature Communications, 2021, vol. 12, issue 1, 1-6

Abstract: Abstract Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that immunological differences may impact the effectiveness of antibody-based treatments such as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma likely reflects the antigenic composition of local viral strains, we hypothesize that convalescent plasma has a higher efficacy, as defined by death within 30 days of transfusion, when the convalescent plasma donor and treated patient were in close geographic proximity. Results of a series of modeling techniques applied to approximately 28,000 patients from the Expanded Access to Convalescent Plasma program (ClinicalTrials.gov number: NCT04338360) support this hypothesis. This work has implications for the interpretation of clinical studies, the ability to develop effective COVID-19 treatments, and, potentially, for the effectiveness of COVID-19 vaccines as additional locally-evolving variants continue to emerge.

Date: 2021
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DOI: 10.1038/s41467-021-25113-5

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