Fresh frozen plasma for neutralizing SARS-CoV-2: "An exploratory cross-sectional study and review of the state of the art"

Abstract

Restitution of humoral immunodeficiency is essential to clear SARS-CoV-2. Intravenous unspecific immunoglobulins are expensive and restricted. So recently donated fresh frozen plasma (FFP) could be useful in this scenario but, are all units neutralizing against SARS-CoV-2? We explored this on 52 donations obtained from "Centro de Transfusión, Tejidos y Células de Málaga, Spain", from April to June 2022. Donors status about SARS-CoV-2 previous infection or vaccination was unknown. Neutralizing activity (at dilutions≥1/160) against real Delta (not circulating), BA.2 (dominant circulating variant), BA.5 (irrupting variant), and BQ.1.1 and XBB.1.5 (not circulating yet) was determined. Higher anti-Spike IgG antibodies cut-offs predicted efficacy of FFP. Different cut-offs have been reported in the literature, but all papers have in common that levels over the higher range of quantification can predict neutralizing activity of recently donated FFP against circulating variants of concern, if used early after donation, not requiring clinical data from donors.

Keywords: Actividad neutralizante; Anticuerpos IgG frente a la espiga del SARS-CoV-2; COVID-19; Fresh frozen plasma; Humoral immunodeficiency; Immunocompromised patients; Inmunodeficiencia humoral; Neutralization activity; Pacientes inmunodeprimidos; Plasma fresco congelado; SARS-CoV-2 anti-Spike IgG.