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Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program.
Transfusion. 2020 12; 60(12):2938-2951.T

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients.

METHODS AND MATERIALS

Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays.

RESULTS

Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer.

CONCLUSIONS

RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody.

Authors+Show Affiliations

Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil.Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil.Hospital Sírio-Libanês, São Paulo, Brazil.Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil.Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil.Hospital Sírio-Libanês, São Paulo, Brazil.Infectious Disease Department, University of São Paulo Medical School, São Paulo, Brazil.Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil.Hospital Sírio-Libanês, São Paulo, Brazil.Albert Einstein Jewish Institute for Education and Research, São Paulo, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32935877

Citation

Wendel, Silvano, et al. "Screening for SARS-CoV-2 Antibodies in Convalescent Plasma in Brazil: Preliminary Lessons From a Voluntary Convalescent Donor Program." Transfusion, vol. 60, no. 12, 2020, pp. 2938-2951.
Wendel S, Kutner JM, Machado R, et al. Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion. 2020;60(12):2938-2951.
Wendel, S., Kutner, J. M., Machado, R., Fontão-Wendel, R., Bub, C., Fachini, R., Yokoyama, A., Candelaria, G., Sakashita, A., Achkar, R., Hamerschlak, N., Scuracchio, P., Amaral, M., Dal Ben, M., Araujo, D., Soares, C., Camargo, A., Kallás, E., Durigon, E., ... Rizzo, L. V. (2020). Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion, 60(12), 2938-2951. https://doi.org/10.1111/trf.16065
Wendel S, et al. Screening for SARS-CoV-2 Antibodies in Convalescent Plasma in Brazil: Preliminary Lessons From a Voluntary Convalescent Donor Program. Transfusion. 2020;60(12):2938-2951. PubMed PMID: 32935877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. AU - Wendel,Silvano, AU - Kutner,Jose Mauro, AU - Machado,Rafael, AU - Fontão-Wendel,Rita, AU - Bub,Carolina, AU - Fachini,Roberta, AU - Yokoyama,Ana, AU - Candelaria,Gabriela, AU - Sakashita,Araci, AU - Achkar,Ruth, AU - Hamerschlak,Nelson, AU - Scuracchio,Patricia, AU - Amaral,Marcelo, AU - Dal Ben,Mirian, AU - Araujo,Danielle, AU - Soares,Camila, AU - Camargo,Anamaria, AU - Kallás,Esper, AU - Durigon,Edison, AU - Reis,Luiz Fernando, AU - Rizzo,Luiz Vicente, Y1 - 2020/09/16/ PY - 2020/06/23/received PY - 2020/08/02/revised PY - 2020/08/02/accepted PY - 2020/9/17/pubmed PY - 2020/12/29/medline PY - 2020/9/16/entrez KW - COVID-19 KW - SARS-COV-2; coronavirus KW - convalescent plasma therapy KW - passive immune therapy SP - 2938 EP - 2951 JF - Transfusion JO - Transfusion VL - 60 IS - 12 N2 - BACKGROUND: Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. METHODS AND MATERIALS: Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. RESULTS: Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. CONCLUSIONS: RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody. SN - 1537-2995 UR - https://www.unboundmedicine.com/medline/citation/32935877/Screening_for_SARS_CoV_2_antibodies_in_convalescent_plasma_in_Brazil:_Preliminary_lessons_from_a_voluntary_convalescent_donor_program_ L2 - https://doi.org/10.1111/trf.16065 DB - PRIME DP - Unbound Medicine ER -