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Yoon HA, Bartash R, Gendlina I, Rivera J, Nakouzi A, Bortz RH, Wirchnianski AS, Paroder M, Fehn K, Serrano-Rahman L, Babb R, Sarwar UN, Haslwanter D, Laudermilch E, Florez C, Dieterle ME, Jangra RK, Fels JM, Tong K, Mariano MC, Vergnolle O, Georgiev GI, Herrera NG, Malonis RJ, Quiroz JA, Morano NC, Krause GJ, Sweeney JM, Cowman K, Allen S, Annam J, Applebaum A, Barboto D, Khokhar A, Lally BJ, Lee A, Lee M, Malaviya A, Sample R, Yang XA, Li Y, Ruiz R, Thota R, Barnhill J, Goldstein DY, Uehlinger J, Garforth SJ, Almo SC, Lai JR, Gil MR, Fox AS, Chandran K, Wang T, Daily JP, Pirofski LA. Treatment of severe COVID-19 with convalescent plasma in Bronx, NYC. JCI Insight 2021; 6:142270. [PMID: 33476300 PMCID: PMC7934933 DOI: 10.1172/jci.insight.142270] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/13/2021] [Indexed: 01/08/2023] Open
Abstract
Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) may hold promise as a treatment for coronavirus disease 2019 (COVID-19). We compared the mortality and clinical outcome of patients with COVID-19 who received 200 mL of CCP with a spike protein IgG titer ≥ 1:2430 (median 1:47,385) within 72 hours of admission with propensity score-matched controls cared for at a medical center in the Bronx, between April 13 and May 4, 2020. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroid use, and anticoagulation use. There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared with matched controls, CCP recipients less than 65 years had 4-fold lower risk of mortality and 4-fold lower risk of deterioration in oxygenation or mortality at day 28. For CCP recipients, pretransfusion spike protein IgG, IgM, and IgA titers were associated with mortality at day 28 in univariate analyses. No adverse effects of CCP were observed. Our results suggest CCP may be beneficial for hospitalized patients less than 65 years, but data from controlled trials are needed to validate this finding and establish the effect of aging on CCP efficacy.
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Affiliation(s)
- Hyun ah Yoon
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Rachel Bartash
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Inessa Gendlina
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Johanna Rivera
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Microbiology and Immunology and
| | - Antonio Nakouzi
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Microbiology and Immunology and
| | | | - Ariel S. Wirchnianski
- Department of Microbiology and Immunology and
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Karen Fehn
- Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | | | - Rachelle Babb
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Microbiology and Immunology and
| | - Uzma N. Sarwar
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | | | | | - Catalina Florez
- Department of Microbiology and Immunology and
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, New York, USA
| | | | | | | | - Karen Tong
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Margarette C. Mariano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Olivia Vergnolle
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - George I. Georgiev
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Natalia G. Herrera
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ryan J. Malonis
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jose A. Quiroz
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nicholas C. Morano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Gregory J. Krause
- Department of Developmental & Molecular Biology
- Institute for Aging Research, and
| | - Joseph M. Sweeney
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kelsie Cowman
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | | | | | | | - Daniel Barboto
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ahmed Khokhar
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Audrey Lee
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Max Lee
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Reise Sample
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Xiuyi A. Yang
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Yang Li
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rafael Ruiz
- Network Performance Group, Montefiore Medical Center, Bronx, New York, USA
- Division of Hospital Medicine, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Raja Thota
- Network Performance Group, Montefiore Medical Center, Bronx, New York, USA
| | - Jason Barnhill
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, New York, USA
| | | | | | - Scott J. Garforth
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Steven C. Almo
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jonathan R. Lai
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | | | | | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Johanna P. Daily
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Microbiology and Immunology and
| | - Liise-anne Pirofski
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Microbiology and Immunology and
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Yoon HA, Bartash R, Gendlina I, Rivera J, Nakouzi A, Bortz RH, Wirchnianski AS, Paroder M, Fehn K, Serrano-Rahman L, Babb R, Sarwar UN, Haslwanter D, Laudermilch E, Florez C, Dieterle ME, Jangra RK, Fels JM, Tong K, Mariano MC, Vergnolle O, Georgiev GI, Herrera NG, Malonis RJ, Quiroz JA, Morano NC, Krause GJ, Sweeney JM, Cowman K, Allen S, Annam J, Applebaum A, Barboto D, Khokhar A, Lally BJ, Lee A, Lee M, Malaviya A, Sample R, Yang XA, Li Y, Ruiz R, Thota R, Barnhill J, Goldstein DY, Uehlinger J, Garforth SJ, Almo SC, Lai JR, Gil MR, Fox AS, Chandran K, Wang T, Daily JP, Pirofski LA. Treatment of Severe COVID-19 with Convalescent Plasma in the Bronx, NYC. medRxiv 2020:2020.12.02.20242909. [PMID: 33300012 PMCID: PMC7724683 DOI: 10.1101/2020.12.02.20242909] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) may hold promise as treatment for Coronavirus Disease 2019 (COVID-19). We compared the mortality and clinical outcome of patients with COVID-19 who received 200mL of CCP with a Spike protein IgG titer ≥1:2,430 (median 1:47,385) within 72 hours of admission to propensity score-matched controls cared for at a medical center in the Bronx, between April 13 to May 4, 2020. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroids, and anticoagulation use. There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared to matched controls, CCP recipients <65 years had 4-fold lower mortality and 4-fold lower deterioration in oxygenation or mortality at day 28. For CCP recipients, pre-transfusion Spike protein IgG, IgM and IgA titers were associated with mortality at day 28 in univariate analyses. No adverse effects of CCP were observed. Our results suggest CCP may be beneficial for hospitalized patients <65 years, but data from controlled trials is needed to validate this finding and establish the effect of ageing on CCP efficacy.
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Affiliation(s)
- Hyun ah Yoon
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Rachel Bartash
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Inessa Gendlina
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Johanna Rivera
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Antonio Nakouzi
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Robert H. Bortz
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Ariel S. Wirchnianski
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Monika Paroder
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Karen Fehn
- Department of Oncology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Leana Serrano-Rahman
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Rachelle Babb
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Uzma N. Sarwar
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Denise Haslwanter
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Ethan Laudermilch
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Catalina Florez
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
- Department of Chemistry and Life Science, United States Military Academy at West Point, NY
| | - M. Eugenia Dieterle
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Rohit K. Jangra
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - J. Maximilian Fels
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Karen Tong
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | | | - Olivia Vergnolle
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - George I. Georgiev
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Natalia G. Herrera
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Ryan J. Malonis
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Jose A. Quiroz
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Nicholas C. Morano
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Gregory J. Krause
- Department of Developmental and Molecular Biology. Albert Einstein College of Medicine, Bronx, NY
- Institute of Aging Studies. Albert Einstein College of Medicine, Bronx, NY
| | - Joseph M. Sweeney
- Department Physiology and Biophysics. Albert Einstein College of Medicine, Bronx, NY
| | - Kelsie Cowman
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | | | | | | | | | | | | | - Audrey Lee
- Albert Einstein College of Medicine, Bronx, NY
| | - Max Lee
- Albert Einstein College of Medicine, Bronx, NY
| | | | | | | | - Yang Li
- Department of Epidemiology and Population Health. Albert Einstein College of Medicine, Bronx, NY
| | - Rafael Ruiz
- Network Performance Group. Montefiore Medical Center, Bronx, NY
- Division of Hospital Medicine, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Raja Thota
- Network Performance Group. Montefiore Medical Center, Bronx, NY
| | - Jason Barnhill
- Department of Chemistry and Life Science, United States Military Academy at West Point, NY
| | - Doctor Y. Goldstein
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Joan Uehlinger
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Scott J. Garforth
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Steven C. Almo
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
- Department Physiology and Biophysics. Albert Einstein College of Medicine, Bronx, NY
| | - Jonathan R. Lai
- Department of Biochemistry. Albert Einstein College of Medicine, Bronx, NY
| | - Morayma Reyes Gil
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Amy S. Fox
- Department of Pathology. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Kartik Chandran
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Tao Wang
- Department of Epidemiology and Population Health. Albert Einstein College of Medicine, Bronx, NY
| | - Johanna P. Daily
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
| | - Liise-anne Pirofski
- Division of Infectious Diseases, Department of Medicine. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
- Department of Microbiology and Immunology. Albert Einstein College of Medicine, Bronx, NY
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