@article{2999778,
    title = "Kinetics of nucleocapsid, spike and neutralizing antibodies, and viral load in patients with severe covid-19 treated with convalescent plasma",
    author = "Thomopoulos, T.P. and Rosati, M. and Terpos, E. and Stellas, D. and Hu, X. and Karaliota, S. and Bouchla, A. and Katagas, I. and Antoniadou, A. and Mentis, A. and Papageorgiou, S.G. and Politou, M. and Bear, J. and Donohue, D. and Kotanidou, A. and Kalomenidis, I. and Korompoki, E. and Burns, R. and Pagoni, M. and Grouzi, E. and Labropoulou, S. and Stamoulis, K. and Bamias, A. and Tsiodras, S. and Dimopoulos, M.-A. and Pavlakis, G.N. and Pappa, V. and Felber, B.K.",
    journal = "Virus Bulletin",
    year = "2021",
    volume = "13",
    number = "9",
    publisher = "MDPI",
    issn = "0956-9979",
    doi = "10.3390/v13091844",
    keywords = "convalescent plasma;  immunoglobulin A;  immunoglobulin G;  neutralizing antibody;  virus spike protein;  coronavirus spike glycoprotein;  neutralizing antibody;  virus antibody, antibody response;  antibody titer;  Article;  coronavirus disease 2019;  enzyme linked immunosorbent assay;  extracorporeal oxygenation;  female;  human;  humoral immunity;  immunology;  kinetics;  male;  nasopharyngeal swab;  nonhuman;  polymerase chain reaction;  receptor binding;  reverse transcription polymerase chain reaction;  RNA-binding domain;  Sequential Organ Failure Assessment Score;  Severe acute respiratory syndrome coronavirus 2;  viral clearance;  virology;  virus load;  virus nucleocapsid;  aged;  antibody production;  clinical trial;  host pathogen interaction;  immunology;  kinetics;  middle aged;  multicenter study;  passive immunization;  phase 2 clinical trial;  therapy;  very elderly;  virology;  virus nucleocapsid, Aged;  Aged, 80 and over;  Antibodies, Neutralizing;  Antibodies, Viral;  Antibody Formation;  COVID-19;  Female;  Host-Pathogen Interactions;  Humans;  Immunization, Passive;  Kinetics;  Male;  Middle Aged;  Nucleocapsid;  SARS-CoV-2;  Spike Glycoprotein, Coronavirus;  Viral Load",
    abstract = "COVID-19 is an ongoing pandemic with high morbidity and mortality. Despite meticulous research, only dexamethasone has shown consistent mortality reduction. Convalescent plasma (CP) infusion might also develop into a safe and effective treatment modality on the basis of recent studies and meta-analyses; however, little is known regarding the kinetics of antibodies in CP recipients. To evaluate the kinetics, we followed 31 CP recipients longitudinally enrolled at a median of 3 days post symptom onset for changes in binding and neutralizing antibody titers and viral loads. Antibodies against the complete trimeric Spike protein and the receptor-binding domain (Spike-RBD), as well as against the complete Nucleocapsid protein and the RNA binding domain (N-RBD) were determined at baseline and weekly following CP infusion. Neutralizing antibody (pseudotype NAb) titers were determined at the same time points. Viral loads were determined semi-quantitatively by SARS-CoV-2 PCR. Patients with low humoral responses at entry showed a robust increase of antibodies to all SARS-CoV-2 proteins and Nab, reaching peak levels within 2 weeks. The rapid increase in binding and neutralizing antibodies was paralleled by a concomitant clearance of the virus within the same timeframe. Patients with high humoral responses at entry demonstrated low or no further increases; however, virus clearance followed the same trajectory as in patients with low antibody response at baseline. Together, the sequential immunological and virological analysis of this well-defined cohort of patients early in infection shows the presence of high levels of binding and neutralizing antibodies and potent clearance of the virus. © 2021 by the authors. Licensee MDPI, Basel, Switzerland."
}