Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19

被引：388

作者：

Joyner, M. J. ^{[1
]}

Carter, R. E. ^{[6
]}

Senefeld, J. W. ^{[1
]}

Klassen, S. A. ^{[1
]}

Mills, J. R. ^{[2
]}

Johnson, P. W. ^{[6
]}

Theel, E. S. ^{[2
]}

Wiggins, C. C. ^{[1
]}

Bruno, K. A. ^{[7
]}

Klompas, A. M. ^{[1
]}

Lesser, E. R. ^{[6
]}

Kunze, K. L. ^{[8
]}

Sexton, M. A. ^{[1
]}

Soto, J. C. Diaz ^{[1
]}

Baker, S. E. ^{[1
]}

Shepherd, J. R. A. ^{[1
]}

van Helmond, N. ^{[10
]}

Verdun, N. C. ^{[11
]}

Marks, P. ^{[11
]}

van Buskirk, C. M. ^{[2
]}

Winters, J. L. ^{[2
]}

Stubbs, J. R. ^{[2
]}

Rea, R. F. ^{[3
]}

Hodge, D. O. ^{[6
]}

Herasevich, V. ^{[1
]}

Whelan, E. R. ^{[7
]}

Clayburn, A. J. ^{[1
]}

Larson, K. F. ^{[3
]}

Ripoll, J. G. ^{[1
]}

Andersen, K. J. ^{[1
]}

Buras, M. R. ^{[8
]}

Vogt, M. N. P. ^{[1
]}

Dennis, J. J. ^{[1
]}

Regimbal, R. J. ^{[1
]}

Bauer, P. R. ^{[5
]}

Blair, J. E. ^{[9
]}

Paneth, N. S. ^{[13
,14
]}

Fairweather, D. L. ^{[7
]}

Wright, R. S. ^{[3
,4
]}

Casadevall, A. ^{[12
]}

机构：

[1] Mayo Clin, Dept Anesthesiol & Perioperat Med, 200 First St SW, Rochester, MN 55905 USA

[2] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA

[3] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA

[4] Mayo Clin, Human Res Protect Program, Rochester, MN USA

[5] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, Rochester, MN USA

[6] Mayo Clin, Dept Hlth Sci Res, Jacksonville, FL 32224 USA

[7] Mayo Clin, Dept Cardiovasc Med, Jacksonville, FL 32224 USA

[8] Mayo Clin, Dept Hlth Sci Res, Phoenix, AZ USA

[9] Mayo Clin, Dept Internal Med, Div Infect Dis, Phoenix, AZ USA

[10] Rowan Univ, Cooper Univ Hlth Care, Cooper Med Sch, Dept Anesthesiol, Camden, NJ USA

[11] US FDA, Ctr Biol Evaluat & Res, Silver Spring, MD USA

[12] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mol Microbiol & Immunol, Baltimore, MD USA

[13] Michigan State Univ, Coll Human Med, Dept Epidemiol & Biostat, E Lansing, MI 48824 USA

[14] Michigan State Univ, Coll Human Med, Dept Pediat & Human Dev, E Lansing, MI 48824 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2021年 / 384卷 / 11期

基金：

加拿大自然科学与工程研究理事会;

关键词：

INFLUENZA; THERAPY;

D O I：

10.1056/NEJMoa2031893

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Convalescent plasma has been widely used to treat coronavirus disease 2019 (Covid-19) under the presumption that such plasma contains potentially therapeutic antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can be passively transferred to the plasma recipient. Whether convalescent plasma with high antibody levels rather than low antibody levels is associated with a lower risk of death is unknown. METHODS In a retrospective study based on a U.S. national registry, we determined the antiSARS-CoV-2 IgG antibody levels in convalescent plasma used to treat hospitalized adults with Covid-19. The primary outcome was death within 30 days after plasma transfusion. Patients who were enrolled through July 4, 2020, and for whom data on anti-SARS-CoV-2 antibody levels in plasma transfusions and on 30-day mortality were available were included in the analysis. RESULTS Of the 3082 patients included in this analysis, death within 30 days after plasma transfusion occurred in 115 of 515 patients (22.3%) in the high-titer group, 549 of 2006 patients (27.4%) in the medium-titer group, and 166 of 561 patients (29.6%) in the low-titer group. The association of anti-SARS-CoV-2 antibody levels with the risk of death from Covid-19 was moderated by mechanical ventilation status. A lower risk of death within 30 days in the high-titer group than in the low-titer group was observed among patients who had not received mechanical ventilation before transfusion (relative risk, 0.66; 95% confidence interval [CI], 0.48 to 0.91), and no effect on the risk of death was observed among patients who had received mechanical ventilation (relative risk, 1.02; 95% CI, 0.78 to 1.32). CONCLUSIONS Among patients hospitalized with Covid-19 who were not receiving mechanical ventilation, transfusion of plasma with higher anti-SARS-CoV-2 IgG antibody levels was associated with a lower risk of death than transfusion of plasma with lower antibody levels.

引用

页码：1015 / 1027

页数：13

共 39 条

[1] Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study [J].

Abolghasemi, Hassan ;

Eshghi, Peyman ;

Cheraghali, Abdol Majid ;

Fooladi, Abbas Ali Imani ;

Moghaddam, Farzaneh Bolouki ;

Imanizadeh, Sina ;

Maleki, Matin Moeini ;

Ranjkesh, Mohammad ;

Rezapour, Mohammad ;

Bahramifar, Ali ;

Einollahi, Behzad ;

Hosseini, Mohammad Javad ;

Jafari, Nematollah Joneidi ;

Nikpouraghdam, Mohamad ;

Sadri, Nariman ;

Tazik, Mokhtar ;

Sali, Shanaz ;

Okati, Shamsi ;

Askari, Elham ;

Tabarsi, Payam ;

Aslani, Jafar ;

Sharifipour, Ehsan ;

Jarahzadeh, Mohammad Hossein ;

Khodakarim, Nastaran ;

Salesi, Mahmood ;

Jafari, Ramezan ;

Shahverdi, Samira .

TRANSFUSION AND APHERESIS SCIENCE, 2020, 59 (05)

[2] Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial) [J].

Agarwal, Anup ;

Mukherjee, Aparna ;

Kumar, Gunjan ;

Chatterjee, Pranab ;

Bhatnagar, Tarun ;

Malhotra, Pankaj .

BMJ-BRITISH MEDICAL JOURNAL, 2020, 371

[3]

Altuntas F, 2020, TRANSFUS APHER SCI

[4]

Avendano-Sola C, 2020, MEDRXIV, DOI [10.1101/2020.08.26.20182444v3, DOI 10.1101/2020.08.26.20182444V3]

[5]

Beigel JH, 2020, NEW ENGL J MED, V383, P994, DOI 10.1056/NEJMc2022236

[6] Deployment of convalescent plasma for the prevention and treatment of COVID-19 [J].

Bloch, Evan M. ;

Shoham, Shmuel ;

Casadevall, Arturo ;

Sachals, Bruce S. ;

Shaz, Beth ;

Winters, Jeffrey L. ;

van Buskirk, Camille ;

Grossman, Brenda J. ;

Joyner, Michael ;

Henderson, Jeffrey P. ;

Pekosz, Andrew ;

Lau, Bryan ;

Wesolowski, Amy ;

Katz, Louis ;

Shan, Hua ;

Auwaerter, Paul G. ;

Thomas, David ;

Sullivan, David J. ;

Paneth, Nigel ;

Gehrie, Eric ;

Spitalnik, Steven ;

Hod, Eldad A. ;

Pollack, Lewis ;

Nicholson, Wayne T. ;

Pirofski, Liise-Anne ;

Bailey, Jeffrey A. ;

Tobian, Aaron A. R. .

JOURNAL OF CLINICAL INVESTIGATION, 2020, 130 (06) :2757-2765

[7] RETURN TO THE PAST - THE CASE FOR ANTIBODY-BASED THERAPIES IN INFECTIOUS-DISEASES [J].

CASADEVALL, A ;

SCHARFF, MD .

CLINICAL INFECTIOUS DISEASES, 1995, 21 (01) :150-161

[8] SERUM THERAPY REVISITED - ANIMAL-MODELS OF INFECTION AND DEVELOPMENT OF PASSIVE ANTIBODY THERAPY [J].

CASADEVALL, A ;

SCHARFF, MD .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1994, 38 (08) :1695-1702

[9]

Donato M, 2020, CLIN LAB EVALUATION, DOI [10.1101/2020.07.20.20156398v3, DOI 10.1101/2020.07.20.20156398V3]

[10] Effectiveness of convalescent plasma therapy in severe COVID-19 patients [J].

Duan, Kai ;

Liu, Bende ;

Li, Cesheng ;

Zhang, Huajun ;

Yu, Ting ;

Qu, Jieming ;

Zhou, Min ;

Chen, Li ;

Meng, Shengli ;

Hu, Yong ;

Peng, Cheng ;

Yuan, Mingchao ;

Huang, Jinyan ;

Wang, Zejun ;

Yu, Jianhong ;

Gao, Xiaoxiao ;

Wang, Dan ;

Yu, Xiaoqi ;

Li, Li ;

Zhang, Jiayou ;

Wu, Xiao ;

Li, Bei ;

Xu, Yanping ;

Chen, Wei ;

Peng, Yan ;

Hu, Yeqin ;

Lin, Lianzhen ;

Liu, Xuefei ;

Huang, Shihe ;

Zhou, Zhijun ;

Zhang, Lianghao ;

Wang, Yue ;

Zhang, Zhi ;

Deng, Kun ;

Xia, Zhiwu ;

Gong, Qin ;

Zhang, Wei ;

Zheng, Xiaobei ;

Liu, Ying ;

Yang, Huichuan ;

Zhou, Dongbo ;

Yu, Ding ;

Hou, Jifeng ;

Shi, Zhengli ;

Chen, Saijuan ;

Chen, Zhu ;

Zhang, Xinxin ;

Yang, Xiaoming .

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2020, 117 (17) :9490-9496

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