Convalescent plasma with a high level of virus-specific antibody effectively neutralizes SARS-CoV-2 variants of concern
Li, Maggie ; Gerber, Jonathan M ; Sullivan, David J
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Abstract
The ongoing evolution of SARS-Co-V2 variants to omicron severely limits available effective monoclonal antibody therapies. Effective drugs are also supply limited. Covid-19 convalescent plasma (CCP) qualified for high antibody levels effectively reduces immunocompetent outpatient hospitalization. The FDA currently allows outpatient CCP for the immunosuppressed. Viral specific antibody levels in CCP can range ten- to hundred-fold between donors unlike the uniform viral specific monoclonal antibody dosing. Limited data are available on the efficacy of polyclonal CCP to neutralize variants. We examined 108 pre-delta/pre-omicron donor units obtained before March 2021, 20 post-delta COVID-19/post-vaccination units and one pre-delta/pre-omicron hyperimmunoglobulin preparation for variant specific virus (vaccine-related isolate (WA-1), delta and omicron) neutralization correlated to Euroimmun S1 IgG antibody levels. We observed a 2- to 4-fold and 20- to 40-fold drop in virus neutralization from SARS-CoV-2 WA-1 to delta or omicron, respectively. CCP antibody levels in the upper 10% of the 108 donations as well as 100% of the post-delta COVID-19/post-vaccination units and the hyperimmunoglobulin effectively neutralized all three variants. High-titer CCP neutralizes SARS-CoV-2 variants despite no previous donor exposure to the variants.
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Li M, Beck EJ, Laeyendecker O, Eby Y, Tobian AA, Caturegli P, Wouters C, Chiklis GR, Block W, McKie RO, Joyner MJ, Wiltshire TD, Dietz AB, Gniadek TJ, Shapiro AS, Yarava A, Lane K, Hanley DF, Bloch EM, Shoham S, Cachay ER, Meisenberg BR, Huaman MA, Fukuta Y, Patel B, Heath SL, Levine AC, Paxton JH, Anjan S, Gerber JM, Gebo KA, Casadevall A, Pekosz A, Sullivan DJ. Convalescent plasma with a high level of virus-specific antibody effectively neutralizes SARS-CoV-2 variants of concern. Blood Adv. 2022 Apr 20:bloodadvances.2022007410. doi: 10.1182/bloodadvances.2022007410. Epub ahead of print. PMID: 35443020; PMCID: PMC9023079. Link to article on publisher's site
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Full author list omitted for brevity. For the full list of authors, see article.