Outpatient treatment with concomitant vaccine-boosted convalescent plasma for patients with immunosuppression and COVID-19
Although severe coronavirus disease 2019 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. In addition, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 ("vax-plasma"). Thus, we report the clinical outcome of 386 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19-specific therapeutics (standard-of-care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 2.2% (5 of 225 patients) in the vax-plasma group and 6.2% (10 of 161 patients) in the standard-of-care group, which corresponded to a relative risk reduction of 65% (P = 0.046). Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (361 of 386 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19-specific therapies reduced the risk of disease progression leading to hospitalization.IMPORTANCEAs SARS-CoV-2 evolves, new variants of concern (VOCs) have emerged that evade available anti-spike monoclonal antibodies, particularly among immunosuppressed patients. However, high-titer COVID-19 convalescent plasma continues to be effective against VOCs because of its broad-spectrum immunomodulatory properties. Thus, we report clinical outcomes of 386 immunocompromised outpatients who were treated with COVID-19-specific therapeutics and a subgroup also treated with vaccine-boosted convalescent plasma. We found that the administration of vaccine-boosted convalescent plasma was associated with a significantly decreased incidence of hospitalization among immunocompromised COVID-19 outpatients. Our data add to the contemporary data providing evidence to support the clinical utility of high-titer convalescent plasma as antibody replacement therapy in immunocompromised patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
mBio - (2024) vom: 11. Apr., Seite e0040024 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ripoll, Juan G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Antibody therapy |
|---|
| Anmerkungen: |
Date Revised 11.04.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1128/mbio.00400-24 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370917340 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370917340 | ||
| 003 | DE-627 | ||
| 005 | 20240411233423.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240411s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1128/mbio.00400-24 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1372.xml |
| 035 | |a (DE-627)NLM370917340 | ||
| 035 | |a (NLM)38602414 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ripoll, Juan G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outpatient treatment with concomitant vaccine-boosted convalescent plasma for patients with immunosuppression and COVID-19 |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 11.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Although severe coronavirus disease 2019 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. In addition, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 ("vax-plasma"). Thus, we report the clinical outcome of 386 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19-specific therapeutics (standard-of-care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 2.2% (5 of 225 patients) in the vax-plasma group and 6.2% (10 of 161 patients) in the standard-of-care group, which corresponded to a relative risk reduction of 65% (P = 0.046). Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (361 of 386 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19-specific therapies reduced the risk of disease progression leading to hospitalization.IMPORTANCEAs SARS-CoV-2 evolves, new variants of concern (VOCs) have emerged that evade available anti-spike monoclonal antibodies, particularly among immunosuppressed patients. However, high-titer COVID-19 convalescent plasma continues to be effective against VOCs because of its broad-spectrum immunomodulatory properties. Thus, we report clinical outcomes of 386 immunocompromised outpatients who were treated with COVID-19-specific therapeutics and a subgroup also treated with vaccine-boosted convalescent plasma. We found that the administration of vaccine-boosted convalescent plasma was associated with a significantly decreased incidence of hospitalization among immunocompromised COVID-19 outpatients. Our data add to the contemporary data providing evidence to support the clinical utility of high-titer convalescent plasma as antibody replacement therapy in immunocompromised patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a antibody therapy | |
| 650 | 4 | |a immunocompromised hosts | |
| 700 | 1 | |a Tulledge-Scheitel, Sidna M |e verfasserin |4 aut | |
| 700 | 1 | |a Stephenson, Anthony A |e verfasserin |4 aut | |
| 700 | 1 | |a Ford, Shane |e verfasserin |4 aut | |
| 700 | 1 | |a Pike, Marsha L |e verfasserin |4 aut | |
| 700 | 1 | |a Gorman, Ellen K |e verfasserin |4 aut | |
| 700 | 1 | |a Hanson, Sara N |e verfasserin |4 aut | |
| 700 | 1 | |a Juskewitch, Justin E |e verfasserin |4 aut | |
| 700 | 1 | |a Miller, Alex J |e verfasserin |4 aut | |
| 700 | 1 | |a Zaremba, Solomiia |e verfasserin |4 aut | |
| 700 | 1 | |a Ovrom, Erik A |e verfasserin |4 aut | |
| 700 | 1 | |a Razonable, Raymund R |e verfasserin |4 aut | |
| 700 | 1 | |a Ganesh, Ravindra |e verfasserin |4 aut | |
| 700 | 1 | |a Hurt, Ryan T |e verfasserin |4 aut | |
| 700 | 1 | |a Fischer, Erin N |e verfasserin |4 aut | |
| 700 | 1 | |a Derr, Amber N |e verfasserin |4 aut | |
| 700 | 1 | |a Eberle, Michele R |e verfasserin |4 aut | |
| 700 | 1 | |a Larsen, Jennifer J |e verfasserin |4 aut | |
| 700 | 1 | |a Carney, Christina M |e verfasserin |4 aut | |
| 700 | 1 | |a Theel, Elitza S |e verfasserin |4 aut | |
| 700 | 1 | |a Parikh, Sameer A |e verfasserin |4 aut | |
| 700 | 1 | |a Kay, Neil E |e verfasserin |4 aut | |
| 700 | 1 | |a Joyner, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Senefeld, Jonathon W |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t mBio |d 2010 |g (2024) vom: 11. Apr., Seite e0040024 |w (DE-627)NLM200128191 |x 2150-7511 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:11 |g month:04 |g pages:e0040024 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1128/mbio.00400-24 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 11 |c 04 |h e0040024 | ||