COVID-19 outcome is not affected by anti-CD20 or high-titer convalescent plasma in immunosuppressed patients

DOI record: { "DOI": "10.1038/s41598-023-48145-x", "ISSN": [ "2045-2322" ], "URL": "http://dx.doi.org/10.1038/s41598-023-48145-x", "abstract": "<jats:title>Abstract</jats:title><jats:p>The role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) convalescent plasma in the treatment of Coronavirus Disease 2019 (COVID-19) in immunosuppressed individuals remains controversial. We describe the course of COVID-19 in patients who had received anti-CD20 therapy within the 3 years prior to infection. We compared outcomes between those treated with and those not treated with high titer SARS-CoV2 convalescent plasma. We identified 144 adults treated at Mayo clinic sites who had received anti-CD20 therapies within a median of 5.9 months prior to the COVID-19 index date. About one-third (34.7%) were hospitalized within 14 days and nearly half (47.9%) within 90 days. COVID-19 directed therapy included anti-spike monoclonal antibodies (n = 30, 20.8%), and, among those hospitalized within 14 days (n = 50), remdesivir (n = 45, 90.0%), glucocorticoids (n = 36, 72.0%) and convalescent plasma (n = 24, 48.0%). The duration from receipt of last dose of anti-CD20 therapy did not correlate with outcomes. The overall 90-day mortality rate was 14.7%. Administration of convalescent plasma within 14 days of the COVID-19 diagnosis was not significantly associated with any study outcome. Further study of COVID-19 in CD20-depleted individuals is needed focusing on the early administration of new and potentially combination antiviral agents, associated or not with vaccine-boosted convalescent plasma.</jats:p>", "alternative-id": [ "48145" ], "article-number": "21249", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "22 September 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "22 November 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "1 December 2023" }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 1, "value": "Mary J. Kasten, M.D.: Stockholder: Abbott Laboratories, AbbVie, Amgen, Eli Lilly, Bristol Myers Squib, Amgen, Merck, GlaxoSmithKline, Baxter International, Pfizer, CVS Health Corporation, Viatris Inc, Medtronic, Zimmer Biomet, Masimo Corp, Takeda Pharmaceutical\nJohn C. O’Horo, M.D., M.P.H.: Grants from Nference, Inc and the MITRE corporation for COVID-19 research unrelated to the present work.\nRaymund R. Razonable, M.D.: research grants (funds to the institution) from Gilead, Regeneron and Roche; member of the Data and Safety Monitoring Board (Novartis) and Endpoint Adjudication Committee (Allovir); member of the Board of Directors, American Society of Transplantation\nPaschalis Vergidis, M.D.: research support from Ansun, Cidara, Scynexis and consultant AbbVie with all fees being paid to Mayo Clinic\nAll other authors declare no conflicts of interests." } ], "author": [ { "affiliation": [], "family": "Kasten", "given": "Mary J.", "sequence": "first" }, { "affiliation": [], "family": "Lahr", "given": "Brian D.", "sequence": "additional" }, { "affiliation": [], "family": "Parisapogu", "given": "Anusha", "sequence": "additional" }, { "affiliation": [], "family": "Yetmar", "given": "Zachary A.", "sequence": "additional" }, { "affiliation": [], "family": "O’Horo", "given": "John C.", "sequence": "additional" }, { "affiliation": [], "family": "Orenstein", "given": "Robert", "sequence": "additional" }, { "affiliation": [], "family": "Moreno Franco", "given": "Pablo", "sequence": "additional" }, { "affiliation": [], "family": "Razonable", "given": "Raymund R.", "sequence": "additional" }, { "affiliation": [], "family": "Vergidis", "given": "Paschalis", "sequence": "additional" }, { "affiliation": [], "family": "Shah", "given": "Aditya S.", "sequence": "additional" }, { "affiliation": [], "family": "Enzler", "given": "Mark J.", "sequence": "additional" }, { "affiliation": [], "family": "Inwards", "given": "David J.", "sequence": "additional" }, { "affiliation": [], "family": "Bauer", "given": "Philippe R.", "sequence": "additional" } ], "container-title": "Scientific Reports", "container-title-short": "Sci Rep", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2023, 12, 1 ] ], "date-time": "2023-12-01T18:02:17Z", "timestamp": 1701453737000 }, "deposited": { "date-parts": [ [ 2023, 12, 1 ] ], "date-time": "2023-12-01T18:11:18Z", "timestamp": 1701454278000 }, "funder": [ { "DOI": "10.13039/100000871", "doi-asserted-by": "crossref", "name": "Mayo Clinic" } ], "indexed": { "date-parts": [ [ 2023, 12, 2 ] ], "date-time": "2023-12-02T00:56:52Z", "timestamp": 1701478612692 }, "is-referenced-by-count": 0, "issue": "1", "issued": { "date-parts": [ [ 2023, 12, 1 ] ] }, "journal-issue": { "issue": "1", "published-online": { "date-parts": [ [ 2023, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 12, 1 ] ], "date-time": "2023-12-01T00:00:00Z", "timestamp": 1701388800000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 12, 1 ] ], "date-time": "2023-12-01T00:00:00Z", "timestamp": 1701388800000 } } ], "link": [ { "URL": "https://www.nature.com/articles/s41598-023-48145-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.nature.com/articles/s41598-023-48145-x", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.nature.com/articles/s41598-023-48145-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1038", "published": { "date-parts": [ [ 2023, 12, 1 ] ] }, "published-online": { "date-parts": [ [ 2023, 12, 1 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1056/NEJMoa2118542", "author": "J Hammond", "doi-asserted-by": "publisher", "first-page": "1397", "journal-title": "N. 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