Passive Immunity for Coronavirus Disease 2019: A Commentary on Therapeutic Aspects Including Convalescent Plasma

Abstract

In the ongoing pandemic of coronavirus disease 2019 (COVID-19), the novel virus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is infecting a naïve population. The innate immunity of the infected patient is unable to mount an effective defense, resulting in a severe illness with substantial morbidity and mortality. As most treatment modalities including antivirals and anti-inflammatory agents are mostly ineffective, an immunological approach is needed. The mechanism of innate immunity to this viral illness is not fully understood. Passive immunity becomes an important avenue for the management of these patients. In this article, the immune responses of COVID-19 patients are reviewed. As SARS-CoV-2 has many characteristics in common with two other viruses, SARS-CoV that cause severe acute respiratory syndrome (SARS) and MERS-CoV (Middle East respiratory syndrome coronavirus) that causes Middle East respiratory syndrome (MERS), the experiences learned from the use of passive immunity in treatment can be applied to COVID-19. The immune response includes the appearance of immunoglobulin M followed by immunoglobulin G and neutralizing antibodies. Convalescent plasma obtained from patients recovered from the illness with high titers of neutralizing antibodies was successful in treating many COVID-19 patients. The factors that determine responses as compared with those seen in SARS and MERS are also reviewed. As there are no approved vaccines against all three viruses, it remains a challenge in the ongoing development for an effective vaccine for COVID-19.

Antibody-based immunotherapeutics and use of convalescent plasma to counter COVID-19: advances and prospects

“…In addition, a study recommended the collection of plasma at least 14 to 28 days post-resolution of clinical symptoms associated with COVID-19 [39]. Moreover, on the basis of previous experiences from SARS-CoV, a neutralizing antibody titer greater than 1:40 is recommended for SARS-CoV-2 [39,40]. Further studies may be required to evaluate the therapeutic potential of the convalescent plasma.…”

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“…The latter study highpoints a challenge in using convalescent sera, specifically that some who improve from the viral disease may not have high titers of neutralizing antibody. Dependable with this point, an analysis of 99 samples of convalescent sera from patients with SARS indicated that 87 had neutralizing antibody, with a geometric mean titer of 1: 61 33,34 . This recommends that antibody regressions with time or that some patients make high titer responses.…”

2021 Eberhard F. Mammen Award Announcements: Part I—Most Popular Articles

“…►Table 3 lists the top 20 downloaded "Open Access" articles from STH (2019 and 2020 inclusive), as eligible for the "Open Access" award. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] ►Table 4 lists the top 25 downloaded non-open access articles from STH (2019 and 2020 inclusive), as otherwise eligible for the "'General Category" award. I will note that although I was a coauthor of one of the awardwinning articles, my relative contribution was minor in comparison to the lead author, and I will of course decline to receive any of the award prize.…”