Treatment of severe COVID-19 with convalescent plasma in Bronx, NYC.

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.

Treatment of Severe COVID-19 with Convalescent Plasma in the Bronx, NYC.

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.

Antibody identification using both automated solid-phase red cell adherence assay and a tube polyethylene glycol antiglobulin method.

BACKGROUND: Because antibody identification is labor-intensive, facilities with high volume and/or marginal technical support could benefit from partial automation. STUDY DESIGN AND METHODS: After a validation study of automated solid-phase red cell (RBC) adherence assay (SPRCA; Galileo, Immucor) compared to tube polyethylene glycol antiglobulin antibody identification method (t-PEG), we evaluated Galileo followed by select RBC panels by t-PEG. Of 298 consecutive samples in which antibody identifications were performed in a 2-month period, 160 samples were examined by both Galileo and t-PEG. RESULTS: There were concordant results between Galileo and t-PEG in 120 of 160 (75%) samples including cases with identical alloantibody identification (n = 99), panagglutinin (n = 9), and negative results (n = 12). Of the samples in which alloantibodies were identified, 99 of 108 (91.7%) were identical. In 9 samples with discrepant antibody identifications, 2 samples showed alloantibody specificity by Galileo (possible anti-K and anti-Jk(b)) but were negative by t-PEG. These antibodies were identifiable by t-PEG in subsequent samples. One sample showed anti-E by Galileo, while t-PEG revealed anti-Fy(a) and -E. Five samples showed alloantibody specificity by t-PEG and nonspecific reactivity or panagglutinin by Galileo. These included samples with anti-C (n = 2), anti-E (n = 2), and anti-Fy(a) (n = 1). One sample showed anti-E by t-PEG but was negative by Galileo. Galileo found a panagglutinin in 23 samples and nonspecific reactivity in 22 samples, whereas t-PEG found a panagglutinin in 12 samples but no nonspecific reactivity. CONCLUSIONS: Automated Galileo solid-phase red cell adherence assay can be a useful adjunct for antibody identification, although it detects more nonspecific reactivity than does t-PEG.