TY - JOUR TI - Kinetics of nucleocapsid, spike and neutralizing antibodies, and viral load in patients with severe covid-19 treated with convalescent plasma AU - Thomopoulos, T.P. AU - Rosati, M. AU - Terpos, E. AU - Stellas, D. AU - Hu, X. AU - Karaliota, S. AU - Bouchla, A. AU - Katagas, I. AU - Antoniadou, A. AU - Mentis, A. AU - Papageorgiou, S.G. AU - Politou, M. AU - Bear, J. AU - Donohue, D. AU - Kotanidou, A. AU - Kalomenidis, I. AU - Korompoki, E. AU - Burns, R. AU - Pagoni, M. AU - Grouzi, E. AU - Labropoulou, S. AU - Stamoulis, K. AU - Bamias, A. AU - Tsiodras, S. AU - Dimopoulos, M.-A. AU - Pavlakis, G.N. AU - Pappa, V. AU - Felber, B.K. JO - Virus Bulletin PY - 2021 VL - 13 TODO - 9 SP - null PB - MDPI SN - 0956-9979 TODO - 10.3390/v13091844 TODO - 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 TODO - 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. ER -