[HTML][HTML] Mortality in individuals treated with COVID-19 convalescent plasma varies with the geographic provenance of donors

KL Kunze, PW Johnson, N van Helmond… - Nature …, 2021 - nature.com
KL Kunze, PW Johnson, N van Helmond, JW Senefeld, MM Petersen, SA Klassen
Nature communications, 2021nature.com
Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have
harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that
immunological differences may impact the effectiveness of antibody-based treatments such
as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma
likely reflects the antigenic composition of local viral strains, we hypothesize that …
Abstract
Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that immunological differences may impact the effectiveness of antibody-based treatments such as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma likely reflects the antigenic composition of local viral strains, we hypothesize that convalescent plasma has a higher efficacy, as defined by death within 30 days of transfusion, when the convalescent plasma donor and treated patient were in close geographic proximity. Results of a series of modeling techniques applied to approximately 28,000 patients from the Expanded Access to Convalescent Plasma program (ClinicalTrials.gov number: NCT04338360) support this hypothesis. This work has implications for the interpretation of clinical studies, the ability to develop effective COVID-19 treatments, and, potentially, for the effectiveness of COVID-19 vaccines as additional locally-evolving variants continue to emerge.
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