Convalescent Plasma does not improve in-hospital mortality among low SARS-CoV-2-IgG antibodies in COVID-19 hospitalized patients

Abstract

<b>Background:</b> The use of convalescent plasma (CP) is recommended as an Emergency Use Authorization (EUA) in the USA for patients with COVID-19. However, limited data are available regarding the impact of this. Our aim was to assess the impact on in-hospital mortality after CP administration according to pre-transfusion antibodies in COVID-19 recipients hospitalized with severe COVID-19 infection. Our hypothesis was that patients with low SARS-CoV-2 IgG antibodies are more likely to benefit with the administration of CP. <b>Methods:</b> In this observational cohort study, we enrolled consecutive COVID-19 hospitalized patients presenting with COVID-19 disease &gt;18 years of age. CP was&nbsp;administered after obtaining informed consent as part of standard of care. Prior to the administration of CP, the patient had a blood sample drawn for SARS-CoV-2 IgG (Abbott Laboratories – FDA’s EUA – cut off value: more or equal to 1.4 = Positive). Primary outcome was in-hospital mortality. <b>Results:</b> Among 205 hospitalized patients that received CP for COVID-19, 55 (27%) had SARS-CoV-2 antibodies measured before CP administration. The patient median age was 69 years old (interquartile range [IQR] 60-76) and the majority were men (91%). Low SARS-CoV-2 IgG (&lt;1.4 UI) was identified in 33% of the patients. When comparing low SARS-CoV-2 IgG &lt;1.4 UI vs. low SARS-CoV-2 IgG &gt;1.4 UI, in-hospital mortality was 28% (5/18 patients) compared to 22% (8/37 patients) with an Odds ratio of 0.72 (95% confidence interval 0.20-2.62; p= 0.6), respectively. <b>Conclusion:</b> The administration of CP did not&nbsp;change in-hospital mortality among patients with high or low SARS-CoV-2 IgG antibodies.