COVID-19 outcome is not affected by anti-CD20 or high-titer convalescent plasma in immunosuppressed patients
Mary J Kasten, Brian D Lahr, Anusha Parisapogu, Zachary A Yetmar, John C O’horo, Robert Orenstein, Pablo Moreno Franco, Raymund R Razonable, Paschalis Vergidis, Aditya S Shah, Mark J Enzler, David J Inwards, Philippe R Bauer
Scientific Reports, doi:10.1038/s41598-023-48145-x
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.
Author contributions Authors M.J.K., B.D.L., Z.A.Y., J.C.O., M.J.E., D.J.I., R.R.R., A.S.S., P.V., P.R.B. were all involved with conception and design of the study.Authors M.J.K., A.P., Z.A.Y., J.C.O., M.J.E., P.M.F., R.O., R.R.R., A.S.S., P.V., P.R.B. were all involved in data acquisition.Authors M.J.K., B.D.L., A.P., Z.A.Y., J.C.O., M.J.E., D.J.I., P.M.F., R.O., R.R.R., A.S.S., P.V., P.R.B. were all involved in data interpetation.All Authors M.J.K., B.D.L., A.P., Z.A.Y., J.C.O., M.J.E., D.J.I., P.M.F., R.O., R.R.R., A.S.S., P.V., P.R.B. were involved with drafting and approving the manuscript.
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Supplementary Information The online version contains supplementary material available at https:// doi. org/
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