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Significantly Decreased Mortality in a Large Cohort of Coronavirus Disease 2019 (COVID-19) Patients Transfused Early with Convalescent Plasma Containing High-Titer Anti-Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike Protein IgG.
Salazar, Eric; Christensen, Paul A; Graviss, Edward A; Nguyen, Duc T; Castillo, Brian; Chen, Jian; Lopez, Bevin V; Eagar, Todd N; Yi, Xin; Zhao, Picheng; Rogers, John; Shehabeldin, Ahmed; Joseph, David; Masud, Faisal; Leveque, Christopher; Olsen, Randall J; Bernard, David W; Gollihar, Jimmy; Musser, James M.
  • Salazar E; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
  • Christensen PA; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Graviss EA; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Center for Molecular and Translational Human Infectious Diseases, Houston Methodist Research Institute, Houston, Texas.
  • Nguyen DT; Center for Molecular and Translational Human Infectious Diseases, Houston Methodist Research Institute, Houston, Texas.
  • Castillo B; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Chen J; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Lopez BV; Academic Office of Clinical Trials, Houston Methodist Research Institute, Houston, Texas.
  • Eagar TN; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
  • Yi X; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
  • Zhao P; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Rogers J; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Shehabeldin A; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Joseph D; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Masud F; Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, Texas.
  • Leveque C; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • Olsen RJ; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York; Center for Molecular and Translational Human Infectious Diseases, Houston Methodist Research Institute, Housto
  • Bernard DW; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
  • Gollihar J; The Combat Capabilities Development Command Army Research Laboratory-South, University of Texas at Austin, Austin, Texas.
  • Musser JM; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York; Center for Molecular and Translational Human Infectious Diseases, Houston Methodist Research Institute, Housto
Am J Pathol ; 191(1): 90-107, 2021 01.
Article in English | MEDLINE | ID: covidwho-938719
ABSTRACT
Coronavirus disease 2019 (COVID-19) convalescent plasma has emerged as a promising therapy and has been granted Emergency Use Authorization by the US Food and Drug Administration for hospitalized COVID-19 patients. We recently reported results from interim analysis of a propensity score-matched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing high-titer anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. We herein present results from a 60-day follow-up of a cohort of 351 transfused hospitalized patients. Prospective determination of enzyme-linked immunosorbent assay anti-RBD IgG titer facilitated selection and transfusion of the highest titer units available. Retrospective analysis by the Ortho VITROS IgG assay revealed a median signal/cutoff ratio of 24.0 for transfused units, a value far exceeding the recent US Food and Drug Administration-required cutoff of 12.0 for designation of high-titer convalescent plasma. With respect to altering mortality, our analysis identified an optimal window of 44 hours after hospitalization for transfusing COVID-19 patients with high-titer convalescent plasma. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high-titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulin G / Spike Glycoprotein, Coronavirus / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Pathol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulin G / Spike Glycoprotein, Coronavirus / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Pathol Year: 2021 Document Type: Article