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

Arvind Gharbharan, Carlijn C.E. Jordans, Corine Geurts van Kessel, Jan G. den 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. van Pottelberge, Imro N. Vlasveld, Heidi S.M. Ammerlaan, Elena M. van Leeuwen – Segarceanu, Jelle Miedema, Menno van der Eerden, Thijs J. Schrama, Grigorios PapageorgiouPeter te Boekhorst, Francis H. Swaneveld, Yvonne M. Mueller, Marco W.J. Schreurs, Jeroen J.A. van Kampen, Barry Rockx, Nisreen M.A. Okba, Peter D. Katsikis, Marion P.G. Koopmans, Bart L. Haagmans, Casper Rokx*, Bart J.A. Rijnders

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

61 Citations (Scopus)

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.

Original languageEnglish
Article number3189
Pages (from-to)1-9
JournalNature Communications
Volume12
Issue number1
DOIs
Publication statusPublished - 27 May 2021

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