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[Preprint]. 2022 Mar 2:2022.03.01.22271662.
doi: 10.1101/2022.03.01.22271662.

High Viral Specific Antibody Convalescent Plasma Effectively Neutralizes SARS-CoV-2 Variants of Concern

Maggie Li  1 , Evan J Beck  2 , Oliver Laeyendecker  2 , Yolanda Eby  3 , Aaron Ar Tobian  3 , Patrizio Caturegli  3 , Camille Wouters  1 , Gregory R Chiklis  4 , William Block  5 , Robert McKie  6 , Michael Joyner  7 , Timothy D Wiltshire  8 , Allan B Dietz  8 , Thomas J Gniadek  9 , Arell Shapiro  10 , Anusha Yarava  11 , Karen Lane  11 , Daniel Hanley  11 , Evan M Bloch  3 , Shmuel Shoham  12 , Edward R Cachay  13 , Barry R Meisenberg  14 , Moises A Huaman  15 , Yuriko Fukuta  16 , Bela Patel  17 , Sonya L Heath  18 , Adam C Levine  19 , James H Paxton  20 , Shweta Anjan  21 , Jonathan M Gerber  22 , Kelly A Gebo  12 , Arturo Casadevall  1 , Andrew Pekosz  1 , David J Sullivan  1 ; CSSC group
Affiliations

High Viral Specific Antibody Convalescent Plasma Effectively Neutralizes SARS-CoV-2 Variants of Concern

Maggie Li et al. medRxiv. .

Update in

  • Convalescent plasma with a high level of virus-specific antibody effectively neutralizes SARS-CoV-2 variants of concern.
    Li M, Beck EJ, Laeyendecker O, Eby Y, Tobian AAR, Caturegli P, Wouters C, Chiklis GR, Block W, McKie RO, Joyner MJ, Wiltshire TD, Dietz AB, Gniadek TJ, Shapiro AJ, 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. Li M, et al. Blood Adv. 2022 Jun 28;6(12):3678-3683. doi: 10.1182/bloodadvances.2022007410. Blood Adv. 2022. PMID: 35443020 Free PMC article.

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.

Key points: All of the post-delta COVID-19/post vaccination convalescent plasma effectively neutralizes the omicron and delta variants.High-titer CCP and hyperimmunoglobulin neutralizes SARS-CoV-2 variants despite no previous donor exposure to the variants.

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Conflict of interest statement

Conflict-of-interest disclosure

TG- paid consultant for Fresenius Kabi; GC and RM are on the Board of Innovative Transfusion Medicine; WB-Board of Blood Centers of America; AC- Scientific Advisory Board of Sabtherapeutics (cow-derived human immunoglobulins COVID-19 treatment and other infectious diseases) and Ortho Diagnostics Speakers Bureau; EB- member of the FDA Blood Products Advisory Committee. All other authors report no relevant disclosures.

Figures

Figure 1
Figure 1. Reduction in virus neutralization sorted by plasma type as well as an increase by Euroimmun antibody levels.
A) WA-1, delta and omicron virus microneutralization sorted by the 108 CCP units, post-delta COVID-19, post vaccination and hyperimmunoglobin. IU/mL geometric means are shown above x-axis. B) Antibody levels over 3.5 Euroimmun AU show 85% microneutralization with WA-1 and delta while omicron neutralization requires Euroimmun AU over 10 for 85% of the 108 CCP donors. Post-delta COVID-19/post vaccination retains 100% virus neutralization for the three variants. Virus neutralization is any positive IU/mL over 1. ****p<0.0001; ***p<0.001; **p<0.01
Figure 2
Figure 2. Sorting higher Euroimmun categories indicates virus neutralization to WA-1, delta and omicron.
WA-1 (A), delta (B) and omicron (C) virus microneutralization measured in CCP, post-delta COVID-19/post-vaccination and hyperimmune globulin (HIG) sorted for viral-specific antibody levels by Euroimmun arbitrary units (AU) at 1:101 dilution. IU/mL geometric means are shown above x-axis. ****p<0.0001; ***p<0.001; **p<0.01; *p<0.05
See this image and copyright information in PMC

References

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