Publication: High-Titer Convalescent Plasma Safe, Shows Promise for COVID-19 Care

Research shows plasma with high levels of COVID-19 antibodies improves survival rates for hospitalized patients

A new publication by scientists at Hackensack Meridian Health showed that convalescent plasma — or the use of survivors’ antibodies transfused into sick COVID-19 patients — is safe and significantly improves clinical outcomes when using high levels (titers) of antibodies.

The results published recently in the journal JCI Insights showed that high-titer convalescent plasma transferred the survivor’s antibodies, was safe, and did not prevent the recipients from making their own antibodies.

About the Study

Fifty-one patients were enrolled to receive the plasma. They were split into two groups: one that was hospitalized but did not need mechanical breathing assistance, and one that was receiving such assistance.

The non-mechanically ventilated patients survived at a significantly higher rate (88.9 percent) at the 30-day mark than a comparative group elsewhere in the health network (72.5 percent). Mechanically ventilated patients had a 30-day mortality rate of 46.7 percent, while a comparative group had a 30-day mortality rate of 71 percent.

“We have developed this technique and methodology to save the lives of patients,” said Michele Donato, M.D., FACP, CPE, chief, Stem Cell Transplantation and Cellular Therapy at John Theurer Cancer Center at Hackensack University Medical Center, who is leading the study.

“The know-how is really crucial for this kind of treatment,” said David S. Perlin, Ph.D., the chief scientific officer and senior vice president of the Hackensack Meridian Center for Discovery and Innovation (CDI). “We have demonstrated that when you rigorously qualify donors, and deliver their antibodies into the right patients, it can make a huge difference.”

Identifying ‘Super Donors’

The convalescent plasma program at Hackensack University Medical Center identifies “super donors” — those with the highest levels of neutralizing antibodies — through methodology developed by experts from the CDI.

Patients who received convalescent plasma received high levels (titers) of antibodies, with almost all receiving viral neutralizing anti-spike protein levels at a proportion of 1:1000, or even greater. This compares with some other convalescent plasma programs which have not set elevated thresholds for antibody levels from donors.

Since the antibodies come from survivors who have developed immune responses to the latest strains, plasma may also keep up with the rise of “variants” of the SARS-CoV-2 virus where other interventions may not, according to some experts.

Creating an Outpatient Program

The promising results for the early intervention has led to an ongoing outpatient program at Hackensack University Medical Center, supported by a U.S. Department of Defense grant. The approximately $5.5 million grant will allow the researchers at Hackensack Meridian John Theurer Cancer Center at Hackensack University Medical Center, and their colleagues at the CDI to continue phase 2 testing of the clinical treatments.

The goal of this outpatient work is to treat infected patients within the first 96 hours of symptom onset with the antibodies found in plasma collected from COVID-19 survivors to prevent hospitalization.

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