Kinetics of SARS-CoV-2 antibody responses pre-COVID-19 and post-COVID-19 convalescent plasma transfusion in patients with severe respiratory failure: an observational case-control study.
Kinetics of SARS-CoV-2 antibody responses pre-COVID-19 and post-COVID-19 convalescent plasma transfusion in patients with severe respiratory failure: an observational case-control study.
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DOI：
10.1136/jclinpath-2020-207356
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发表时间：
2022-08
影响因子：
3.4
通讯作者：
Fontaine MJ
中科院分区：
文献类型：
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作者：
Klein MN;Wang EW;Zimand P;Beauchamp H;Donis C;Ward MD;Martinez-Hernandez A;Tabatabai A;Baddley JW;Bloch EM;Mullins KE;Fontaine MJ
虽然可以通过疫苗接种控制SARS-CoV-2大流行，但从COVID-19 （CCP）康复的个体中输入恢复期血浆（CCP）被认为是一种替代治疗方法。我们研究严重呼吸衰竭患者输血CCP是否会增加SARS-CoV-2抗体的血浆滴度并改善临床结果。34例COVID-19患者同意接受CCP输血，并在输血前和输血后连续抽血。采用ELISA法连续测定血浆SARS-CoV-2抗受体结合域（RBD） IgG和IgM滴度，并与对照组（n=68）的连续血浆滴度进行比较。主要结局是30天的生存，次要结局是呼吸机和/或体外膜氧合（ECMO）支持的长度，住院时间（LOS）和重症监护病房（ICU）。将结果与匹配的对照患者（n=34）进行比较。分别用黄土回归法和ORs法比较抗体动力学和临床结果。在CCP输血之前，74%的患者抗rbd血清IgG阳性（中位数为1:3200），81%的患者抗rbd IgM血清阳性（中位数为1:20 20），16%的患者血清阴性。CCP受体的抗体滴度动力学与对照组相似。与对照组相比，CCP受者的生存率、通气和/或ECMO支持持续时间以及ICU和医院LOS相似。在伴有严重呼吸衰竭的COVID-19患者中，CCP输血没有增加SARS-CoV2抗体的动力学，也没有改善临床结果，这表明CCP可能不适合这类患者。
While the SARS-CoV-2 pandemic may be contained through vaccination, transfusion of convalescent plasma (CCP) from individuals who recovered from COVID-19 (CCP) is considered an alternative treatment. We investigate if CCP transfusion in patients with severe respiratory failure increases plasma titres of SARS-CoV-2 antibodies and improves clinical outcomes. Patients with COVID-19 (n=34) were consented for CCP transfusion and serial blood draws pretransfusion and post-transfusion. Plasma SARS-CoV-2 antireceptor binding domain (RBD) IgG and IgM titres were measured by ELISA serially, and compared with serial plasma titre levels from control patients (n=68). The primary outcome was survival at 30 days, and secondary outcomes were length of ventilator and/or extracorporeal membrane oxygenation (ECMO) support, length of stay (LOS) in the hospital and in the intensive care unit (ICU). Outcomes were compared with matched control patients (n=34). Kinetics of antibodies and clinical outcomes were compared using LOess regression and ORs, respectively. Prior to CCP transfusion, 74% of patients were anti-RBD seropositive for IgG (median 1:3200), and 81% were anti-RBD IgM seropositive (median 1:320), while 16% were seronegative. The kinetics of antibody titres in CCP recipients were similar to controls. CCP recipients presented with similar survival, duration on ventilatory and/or ECMO support, as well as ICU and hospital LOS compared with controls. CCP transfusion did not increase the kinetics of SARS-CoV2 antibodies and did not result in improved clinical outcomes in patients with COVID-19 with severe respiratory failure, suggesting that CCP may not be indicated in this category of patients.
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影响因子：
20.3
作者：
Hegerova, Livia;Gooley, Ted A.;Pagel, John M.
通讯作者：
Pagel, John M.
影响因子：
120.7
作者：
Li, Ling;Zhang, Wei;Liu, Zhong
通讯作者：
Liu, Zhong
影响因子：
15.9
作者：
Wang, Yanqun;Zhang, Lu;Zhao, Jincun
通讯作者：
Zhao, Jincun
影响因子：
7.5
作者：
Luetkens T;Metcalf R;Planelles V;Zheng Y;Larragoite ET;Spivak ES;Spivak AM;Steinbach M;Blaylock RC;Avila SV;Hankey KG;Martins TB;Slev PR;Mannuel HD;Sajadi M;Rapoport AP;Atanackovic D
通讯作者：
Atanackovic D
DOI：
10.1136/bmj.m4232
发表时间：
2020-11-03
期刊：
BMJ (Clinical research ed.)
影响因子：
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作者：
通讯作者：
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