Association between COVID-19 convalescent plasma antibody levels and COVID-19 outcomes stratified by clinical status at presentation.

Autor: Park H; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Yu C; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Pirofski LA; Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA., Yoon H; Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA., Wu D; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Li Y; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Tarpey T; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Petkova E; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.; Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA., Antman EM; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Troxel AB; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA. andrea.troxel@nyulangone.org.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Jun 26; Vol. 24 (1), pp. 639. Date of Electronic Publication: 2024 Jun 26.
DOI: 10.1186/s12879-024-09529-0
Abstrakt: Background: There is a need to understand the relationship between COVID-19 Convalescent Plasma (CCP) anti-SARS-CoV-2 IgG levels and clinical outcomes to optimize CCP use. This study aims to evaluate the relationship between recipient baseline clinical status, clinical outcomes, and CCP antibody levels.
Methods: The study analyzed data from the COMPILE study, a meta-analysis of pooled individual patient data from 8 randomized clinical trials (RCTs) assessing the efficacy of CCP vs. control, in adults hospitalized for COVID-19 who were not receiving mechanical ventilation at randomization. SARS-CoV-2 IgG levels, referred to as 'dose' of CCP treatment, were retrospectively measured in donor sera or the administered CCP, semi-quantitatively using the VITROS Anti-SARS-CoV-2 IgG chemiluminescent immunoassay (Ortho-Clinical Diagnostics) with a signal-to-cutoff ratio (S/Co). The association between CCP dose and outcomes was investigated, treating dose as either continuous or categorized (higher vs. lower vs. control), stratified by recipient oxygen supplementation status at presentation.
Results: A total of 1714 participants were included in the study, 1138 control- and 576 CCP-treated patients for whom donor CCP anti-SARS-CoV2 antibody levels were available from the COMPILE study. For participants not receiving oxygen supplementation at baseline, higher-dose CCP (/control) was associated with a reduced risk of ventilation or death at day 14 (OR = 0.19, 95% CrI: [0.02, 1.70], posterior probability Pr(OR < 1) = 0.93) and day 28 mortality (OR = 0.27 [0.02, 2.53], Pr(OR < 1) = 0.87), compared to lower-dose CCP (/control) (ventilation or death at day 14 OR = 0.79 [0.07, 6.87], Pr(OR < 1) = 0.58; and day 28 mortality OR = 1.11 [0.10, 10.49], Pr(OR < 1) = 0.46), exhibiting a consistently positive CCP dose effect on clinical outcomes. For participants receiving oxygen at baseline, the dose-outcome relationship was less clear, although a potential benefit for day 28 mortality was observed with higher-dose CCP (/control) (OR = 0.66 [0.36, 1.13], Pr(OR < 1) = 0.93) compared to lower-dose CCP (/control) (OR = 1.14 [0.73, 1.78], Pr(OR < 1) = 0.28).
Conclusion: Higher-dose CCP is associated with its effectiveness in patients not initially receiving oxygen supplementation, however, further research is needed to understand the interplay between CCP anti-SARS-CoV-2 IgG levels and clinical outcome in COVID-19 patients initially receiving oxygen supplementation.
(© 2024. The Author(s).)
Databáze: MEDLINE
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