- McDyer, John F;
- Azimpouran, Mahzad;
- Durkalski-Mauldin, Valerie L;
- Clevenger, Robert G;
- Yeatts, Sharon D;
- Deng, Xutao;
- Barsan, William;
- Silbergleit, Robert;
- Kassar, Nahed El;
- Popescu, Iulia;
- Dimitrov, Dimiter;
- Li, Wei;
- Lyons, Emily J;
- Lieber, Sophia C;
- Stone, Mars;
- Korley, Frederick K;
- Callaway, Clifton W;
- Dumont, Larry J;
- Norris, Philip J;
- Investigators, for the SIREN-C3PO
Multiple randomized, controlled clinical trials have yielded discordant results regarding the efficacy of convalescent plasma in outpatients, with some showing an approximately 2-fold reduction in risk and others showing no effect. We quantified binding and neutralizing antibody levels in 492 of the 511 participants from the Clinical Trial of COVID-19 Convalescent Plasma in Outpatients (C3PO) of a single unit of COVID-19 convalescent plasma (CCP) versus saline infusion. In a subset of 70 participants, peripheral blood mononuclear cells were obtained to define the evolution of B and T cell responses through day 30. Binding and neutralizing antibody responses were approximately 2-fold higher 1 hour after infusion in recipients of CCP compared with saline plus multivitamin, but levels achieved by the native immune system by day 15 were almost 10-fold higher than those seen immediately after CCP administration. Infusion of CCP did not block generation of the host antibody response or skew B or T cell phenotype or maturation. Activated CD4+ and CD8+ T cells were associated with more severe disease outcome. These data show that CCP leads to a measurable boost in anti-SARS-CoV-2 antibodies but that the boost is modest and may not be sufficient to alter disease course.