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Monoclonal antibodies (MAbs), convalescent plasma (CP) and hyperimmune intravenous immunoglobulins are routinely used to treat COVID-19 patients with autoimmune disorders, organ transplant patients and patients on immunosuppressive drugs. The recent emergence of rapidly spreading SARS-CoV-2 variant of concern (VOC), omicron, contains large number of mutations in the SARS-CoV-2 spike protein.1 Some of these mutations are known to increase resistance to antibodies elicited by prior infections or current SARS-CoV-2 vaccines.2 The omicron variant is resistant to most of the MAbs, including those approved for treatment of SARS-CoV-2 exposed individuals.2 In contrast to individual MAbs, CP from individuals contain a broad array of polyclonal antibodies, some of which may provide protection against currently circulating VOCs. In the hamster model, highly neutralising CP (but not CP with low neutralisation titres) protected animals from virus-induced lung lesions following challenge with ancestral SARS-CoV-2 strain.3 Due to large variability in the SARS-CoV-2 neutralising capacity of CP, the emergency use authorisation for treatment of COVID-19 patients was updated to recommend use of only high-titre CP administered early after SARS-CoV-2 exposure.
Hyperimmune SARS-CoV-2 intravenous immunoglobulins (hCoV-2IG) represent a concentrated form of IgG fractionated from many CP units that are prescreened for the presence of high titre antispike antibodies and predetermined SARS-CoV-2 neutralisation titres (>1:320).4 The effectiveness of hCoV-2 IG products may be hampered by the emergence of new variants, which might be less susceptible to antibodies from recovered COVID-19 patients previously infected with ancestral SARS-COV-2 strains.
To evaluate the therapeutic potential of polyclonal CP and hCoV-2IG against currently circulating dominant SARS-CoV-2 delta and omicron variants, we measured the neutralisation capacity of 7 hCoV-2IG …
Footnotes
Handling editor Josef S Smolen
Contributors Contributorship: designed research: SK and HG.Clinical specimens and unblinded clinical data: HG. Performed assays: FTZ, GG and SK. Contributed to writing: SK and HG.
Funding Antibody response study was supported by FDA’s MCMi grant #OCET 2021-1565 to SK.
Disclaimer The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organisations imply endorsement by the US government.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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