High levels of common cold coronavirus antibodies in convalescent plasma are associated with improved survival in COVID-19 patients

Abstract

Background COVID-19 Convalescent plasma (CCP) is safe and effective, particularly if given at an early stage of the disease. Our study aimed to identify an association between survival and specific antibodies found in CCP. Patients and Methods Patients >18 years of age who were hospitalized with moderate to severe COVID-19 infection and received CCP at the MD Anderson Cancer Center between 4/30/2020 and 8/20/2020 were included in the study. We quantified the levels of anti-SARS-CoV-2 antibodies, as well as antibodies against antigens of other coronavirus strains, in the CCP units and compared antibody levels with patient outcomes. For each antibody, a Bayesian exponential survival time regression model including prognostic variables was fit, and the posterior probability of a beneficial effect (PBE) of higher antibody level on survival time was computed. Results CCP was administered to 44 cancer patients. The median age was 60 years (range 37-84) and 19 (43%) were female. Twelve patients (27%) died of COVID-19-related complications. Higher levels of two non-SARS-CoV-2-specific antibodies, anti-HCoV-OC43 spike IgG and anti-HCoV-HKU1 spike IgG, had PBE = 1.00, and 4 SARS-CoV-2-specific antibodies had PBEs between 0.90 and 0.95. Other factors associated with better survival were shorter time to CCP administration, younger age, and female sex. Conclusions Common cold coronavirus spike IgG antibodies anti-HCoV-OC43 and anti-HCoV-HKU1 may target a common domain for SARS-CoV-2 and other coronaviruses. They provide a promising therapeutic target for monoclonal antibody production.

A human antibody reveals a conserved site on beta-coronavirus spike proteins and confers protection against SARS-CoV-2 infection

“…The findings illustrate that extraneutralizing effector functions of S2 stem bnAbs may be important and need to be investigated to determine their role in viral suppression or clearance. Indeed, recent studies have revealed that cross-reactive antibodies to endemic CoVs could serve as a marker for survival after severe disease (81,82) or protection against COVID-19 (83).…”

Early cross-coronavirus reactive signatures of humoral immunity against COVID-19

“…Annual circulation of common coronaviruses (cCoV) gives rise to broad cross-coronavirus immunity. However, how this cCoV-specific immunity influences the disease trajectory of COVID-19 remains unclear (39)(40)(41)(42)(43)(44)(45)(46). Among the cCoV, the β-coronavirus OC43 circulates annually in the USA (47).…”

COVID-19 Convalescent Plasma Is More than Neutralizing Antibodies: A Narrative Review of Potential Beneficial and Detrimental Co-Factors

“…These findings may also imply convalescent plasma collections (e.g., CCP units with greater NL63 antibody responses and lower HKU1 antibodies) had higher neutralizing antibodies to the SARS-CoV-2 receptor-binding domain (RBD) [ 38 ]. Another study found better outcomes in recipients of CCP units with higher anti-NL63 or anti-OC43 antibodies [ 39 ]; Influenza virus A(H 3 N 2 ) : Antibody binding to an epitope region from SARS-CoV-2 nucleocapsid, termed Ep9, is associated with greater COVID-19 disease severity [ 40 ]. Bioinformatics analysis identified the neuraminidase protein (not present in the influenza vaccine) of influenza virus A(H3N2) as responsible, a strain that circulated widely in 2014 [ 41 ]; Acute malaria infection: Plasmodium infection induces cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 spike protein [ 42 ]; Natural ABO isoagglutinins: The ABO blood group affects COVID-19 incidence and severity, as well as the type and duration of the cellular immune response [ 43 ].…”

“…These findings may also imply convalescent plasma collections (e.g., CCP units with greater NL63 antibody responses and lower HKU1 antibodies) had higher neutralizing antibodies to the SARS-CoV-2 receptor-binding domain (RBD) [ 38 ]. Another study found better outcomes in recipients of CCP units with higher anti-NL63 or anti-OC43 antibodies [ 39 ];…”