COVID-19 patients treated with convalescent plasma. / Covid-19-pasienter behandlet med rekonvalesensplasma.

BACKGROUND: In Norway, treatment with COVID-19 convalescent plasma has been given through the NORPLASMA project. The treatment was initially offered to critically ill patients after an individual assessment, but from December 2020, the indication was limited to critically ill, immunocompromised patients. In this article we describe clinical characteristics, comorbidity and mortality in patients who received convalescent plasma in these two periods. MATERIAL AND METHOD: From 22 April 2020 to 30 March 2022, a total of 79 patients were included in the observational studies NORPLASMA MONITOR and the Norwegian SARS-CoV-2 study. The patients had received a total of 193 units of convalescent plasma at 15 Norwegian hospitals/nursing homes; 62 in South-Eastern Norway Regional Health Authority, 8 in Western Norway Regional Health Authority and 9 in Central Norway Regional Health Authority. Information on immune status, comorbidity and course of infection was retrieved from the patient records after informed written consent was obtained. RESULTS: Of 79 patients with a median age of 65 years (interquartile range 51-⁠73) who were treated with convalescent plasma, 31 (39 %) died during hospitalisation. A total of 59 patients were immunocompromised, and of these, 20 died in hospital compared to 11 of 20 who were assumed to be immunocompetent. Median number of comorbidities was 2 (interquartile range 1-4). The patients received a median of two plasma units (min.-max. 1-21). Two of the patients developed mild allergic skin reactions. INTERPRETATION: Convalescent plasma was well tolerated by patients with COVID-19. Immunocompromised patients may have benefitted from the treatment, with lower mortality than for those assumed to be immunocompetent.

Convalescent plasma from Norwegian blood donors to treat COVID-19. / Rekonvalesensplasma mot covid-19 fremstilt fra norske blodgivere.

BACKGROUND: At the start of the pandemic, the Norwegian Directorate of Health and Norwegian blood banks initiated the production of COVID-19 convalescent plasma within the framework of clinical studies. In this article we describe the blood donors who participated. MATERIAL AND METHOD: Blood donors who had recovered from COVID-19 were recruited to donate single donor plasma for the purpose of patient treatment. Data on the course of infection, leukocyte antibodies and antibody level against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) per plasma unit were registered after informed consent was obtained. We calculated a disease score defined as the total number of self-reported symptoms/findings and hospitalisation where relevant (score 0-⁠11). RESULTS: A total of 1644 plasma units were collected from 266 plasma donors at 12 blood banks. Median disease score was 5 (interquartile range 3-⁠6), and 15 donors had recovered from pneumonia and/or been hospitalised. A total of 599/1644 plasma units from 106/266 donors met our requirement for SARS-CoV-2 antibody content (> 60 % inhibition of virus binding to angiotensin-converting enzyme 2 (ACE2)) or positive virus neutralisation test. The antibody level in donors waned over time following infection, and showed no clear correlation with disease score. INTERPRETATION: The number of symptoms and findings in blood donors could not predict antibody response at individual level, and antibody testing was crucial for the production of effective convalescent plasma.

Sero-prevalence of SARS-CoV-2 antibodies in blood donors during the third wave of infection in Norway, winter/spring 2021.

Cross-sectional studies of the prevalence of anti-SARS-CoV-2 in representative groups are routinely used for surveillance of public health in Norway. The group of blood donors is easily accessible to provide an estimate over the infection prevalence. Repeated testing of returning donors also generates data about the duration of the antibody response following infection and vaccination. The aim of the current study was to provide updated information about the development of the pandemic in the blood donor population, and to estimate the number of asymptomatic donors visiting the blood center, in an effort to evaluate the measures to prevent virus spreading between donors and staff. In the two main blood banks in the Oslo area, all blood donors were offered antibody testing for a period of three months. Almost 12,000 donors were tested, and the mean weekly prevalence of antibody positive donors due to infection was 2.7 % (varied from 2.1 to 4.0 %). The number of donors presenting following vaccination was 810 (6.9 %). An average of 38 % of the infections had been asymptomatic, and 31 % of the antibody-positive donors were unaware of having been infected. In conclusion, the proportion of blood donors seropositive for anti-SARS-CoV-2 in our blood centers was stable whereas the number of vaccinated blood donors rapidly increased. This indicates that the virus spreading in the third wave of infection in the Oslo area mainly happened in groups underrepresented as blood donors. Health care workers prioritized for early vaccination may be overrepresented in the study period.

Irradiation to prevent a fatal transfusion complication. / Bestråling for å hindre en fatal transfusjonskomplikasjon.

Cellular blood components should be irradiated as a preventive measure against transfusion-associated graft-versus-host disease in severely immunocompromised patients.