TY - JOUR
T1 - Long-Term Persistence and Relevant Therapeutic Impact of High-Titer Viral-Neutralizing Antibody in a Convalescent COVID-19 Plasma Super-Donor
T2 - A Case Report
AU - De Rienzo, Mafalda
AU - Foddai, Maria Laura
AU - Conti, Laura
AU - Mandoj, Chiara
AU - Iaboni, Stefano
AU - Saladini, Ilenia
AU - Castilletti, Concetta
AU - Matusali, Giulia
AU - Donno, Davide Roberto
AU - Marchioni, Luisa
AU - Ianniello, Stefania
AU - Corpolongo, Angela
AU - Palange, Maria
AU - Ciliberto, Gennaro
AU - Piaggio, Giulia
AU - De Marco, Federico
N1 - Funding Information:
The study was supported by funds from the Italian Ministry of Health, Ricerca Corrente.
Publisher Copyright:
© Copyright © 2021 De Rienzo, Foddai, Conti, Mandoj, Iaboni, Saladini, Castilletti, Matusali, Donno, Marchioni, Ianniello, Corpolongo, Palange, Ciliberto, Piaggio and De Marco.
PY - 2021/8/23
Y1 - 2021/8/23
N2 - A convalescent, non-severe, patient with COVID-19 was enrolled as a hyper-immune plasma voluntary donor by the Immuno-Hematology and Transfusion Unit of the Regina Elena National Cancer Institute in Rome, under the TSUNAMI national study criteria. During a nearly 6-month period (May–October 2020), the patient was closely monitored and underwent four hyperimmune plasma collections. Serum SARS-CoV-2 (anti-S + anti-N) IgG and IgM, anti-S1 IgA, and neutralizing titers (NTs) were measured. Anti-SARS-CoV-2 antibody levels steadily decreased. No correlation was found between anti-S/anti-N IgG and IgM levels and viral NT, measured by either a microneutralization test or the surrogate RBD/ACE2-binding inhibition test. Conversely, NTs directly correlated with anti-S1 IgA levels. Hyperimmune donor plasma, administered to five SARS-CoV-2 patients with persistent, severe COVID-19 symptoms, induced short-term clinical and pathological improvement. Reported data suggest that high NTs can persist longer than expected, thus widening hyperimmune plasma source, availability, and potential use. In vitro RBD/ACE2-binding inhibition test is confirmed as a convenient surrogate index for neutralizing activity and patients’ follow-up, suitable for clinical settings where biosafety level 3 facilities are not available. IgA levels may correlate with serum neutralizing activity and represent a further independent index for patient evaluation.
AB - A convalescent, non-severe, patient with COVID-19 was enrolled as a hyper-immune plasma voluntary donor by the Immuno-Hematology and Transfusion Unit of the Regina Elena National Cancer Institute in Rome, under the TSUNAMI national study criteria. During a nearly 6-month period (May–October 2020), the patient was closely monitored and underwent four hyperimmune plasma collections. Serum SARS-CoV-2 (anti-S + anti-N) IgG and IgM, anti-S1 IgA, and neutralizing titers (NTs) were measured. Anti-SARS-CoV-2 antibody levels steadily decreased. No correlation was found between anti-S/anti-N IgG and IgM levels and viral NT, measured by either a microneutralization test or the surrogate RBD/ACE2-binding inhibition test. Conversely, NTs directly correlated with anti-S1 IgA levels. Hyperimmune donor plasma, administered to five SARS-CoV-2 patients with persistent, severe COVID-19 symptoms, induced short-term clinical and pathological improvement. Reported data suggest that high NTs can persist longer than expected, thus widening hyperimmune plasma source, availability, and potential use. In vitro RBD/ACE2-binding inhibition test is confirmed as a convenient surrogate index for neutralizing activity and patients’ follow-up, suitable for clinical settings where biosafety level 3 facilities are not available. IgA levels may correlate with serum neutralizing activity and represent a further independent index for patient evaluation.
KW - case report
KW - COVID-19
KW - hyperimmune plasma
KW - IgA
KW - neutralizing antibodies
KW - RBD/ACE2-binding inhibition test
UR - http://www.scopus.com/inward/record.url?scp=85114355055&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85114355055&partnerID=8YFLogxK
U2 - 10.3389/fimmu.2021.690322
DO - 10.3389/fimmu.2021.690322
M3 - Article
C2 - 34497602
AN - SCOPUS:85114355055
VL - 12
SP - 1
EP - 8
JO - Frontiers in Immunology
JF - Frontiers in Immunology
SN - 1664-3224
M1 - 690322
ER -