Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Department of Virology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
J Infect Dis. 2023 Aug 11;228(3):245-250. doi: 10.1093/infdis/jiad070.
Convalescent plasma (CP) treatment of coronavirus disease 2019 (COVID-19) has shown significant therapeutic effect when administered early (eg, Argentinian trial showing reduced hospitalization) but has in general been ineffective (eg, REMAP-CAP trial without improvement during hospitalization). To investigate whether the differences in CP used could explain the different outcomes, we compared neutralizing antibodies, anti-spike IgG, and avidity of CP used in the REMAP-CAP and Argentinian trials and in convalescent vaccinees. We found no difference between the trial plasmas, emphasizing initial patient serostatus as treatment efficacy predictor. By contrast, vaccinee CP showed significantly higher titers and avidity, being preferable for future CP treatment. Clinical Trials Registration. NCT02735707 and NCT04479163.
恢复期血浆(CP)治疗 2019 年冠状病毒病(COVID-19)在早期(例如阿根廷试验显示住院率降低)时显示出显著的治疗效果,但总体上无效(例如 REMAP-CAP 试验住院期间无改善)。为了研究 CP 使用的差异是否可以解释不同的结果,我们比较了 REMAP-CAP 试验和阿根廷试验以及恢复期疫苗接种者中使用的 CP 的中和抗体、抗刺突 IgG 和亲和力。我们发现试验血浆之间没有差异,这强调了初始患者的血清学状态是治疗效果的预测因素。相比之下,疫苗接种者 CP 显示出明显更高的滴度和亲和力,是未来 CP 治疗的首选。临床试验注册。NCT02735707 和 NCT04479163。