Mortality in individuals treated with COVID-19 convalescent plasma varies with the geographic provenance of donors.
Katie L KunzePatrick W JohnsonNoud van HelmondJonathon W SenefeldMolly M PetersenStephen A KlassenChad C WigginsAllan M KlompasKatelyn A BrunoJohn R MillsElitza S TheelMatthew R BurasMichael A GolafsharMatthew A SextonJuan C Diaz SotoSarah E BakerJohn R A ShepherdNicole C VerdunPeter W MarksNigel S PanethDeLisa FairweatherR Scott WrightCamille M van BuskirkJeffrey Lawrence WintersJames R StubbsKatherine A SeneseMichaela C PletschZachary A BuchholtzRobert F ReaVitaly HerasevichEmily R WhelanAndrew J ClayburnKathryn F LarsonJuan G RipollKylie J AndersenElizabeth R LesserMatthew N P VogtJoshua J DennisRiley J RegimbalPhilippe R BauerJanis E BlairArturo CasadevallRickey E CarterMichael J JoynerPublished in: Nature communications (2021)
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.