Convalescent plasma, a treatment by transferring neutralizing anti-viral antibodies and other immunomodulators via plasma transfusion, had been historically proven to provide the clinical improvement of similar infectious diseases. Therefore, convalescent plasma is proposed as one of the promising treatments of COVID-19. However, the use of convalescent plasma to treat COVID-19 patients have raised the dilemma due to the different responses among the patients. A specific setting of convalescent plasma administration needs to be validated.
Factors affecting titer of anti-SARS-CoV-2 antibody
The US Food and Drug Administration (FDA) has suggested that the titers of anti-SARS-COV-2 antibody of more than 1:160 is considered as the effective convalescent plasma. However, the evidence regarding the outcomes of convalescent plasma remained controversial. Recent studies indicated that the titers of the anti-SARS-COV-2 antibody of more than 1:320 from convalescent plasma donors provided clinical improvement for treating COVID-19 patients. However, the titers of anti-SARS-CoV-2 antibody varied in each individual. These titers might be affected by a wide variety of conditions such as host, perinatal, extrinsic, behavioral, and nutritional factors and magnitude of transmission of the COVID-19 in the region. Some studies have been conducted in US and China. However, no study has been conducted in Indonesia to assess the factors of the host and disease course that might affect the titers of anti-SARS-COV-2 antibody. Therefore, this study was conducted to assess the predictors of the titers of anti-SARS-COV-2 antibody among Indonesian convalescent plasma donors.
It is a cross-sectional study conducted in Saiful Anwar General Hospital, Malang, Indonesia. Information of interest, including demographic characteristics, clinical symptoms, comorbidities, laboratory findings, and the titers of anti-SARS-CoV-2 antibody among COVID-19 convalescent plasma donors were collected. The correlation was assessed using multiple logistic regression.
A total of 50 COVID-19 convalescent plasma donors with the titers of anti-SARS-CoV-2 antibody of more than 1:320 and 33 donors with the titers of less than 1:320 were analyzed. Our analysis revealed that convalescent plasma donors with a history of cough, fever, dyspnea, and pneumonia significantly had higher titers of anti-SARS-CoV-2 antibody than asymptomatic donors. Moreover, convalescent plasma donors with elevated levels of eosinophils and immature granulocytes and low levels of albumins had higher levels of anti-SARS-CoV-2 antibody. The titer of antibody was not affected by comorbidities of donors. Our current findings may be used as the additional baseline criteria for selecting the donors of convalescent plasma for the management of COVID-19.
Author: Dr. Laksmi Wulandari, dr., Sp.P(K), FCCP
Details of the research can be viewed here:
https://www.sciencedirect.com/science/article/pii/S2213398421000671
S.O. Wardhani et al. The predictors of high titer of anti-SARS-CoV-2 antibody of convalescent plasma donors. Clinical Epidemiology and Global Health 11 (2021) 100763 https://doi.org/10.1016/j.cegh.2021.100763
