Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: a single centre

Jae-Hoon Ko1,2, Hyeri Seok1, Sun Young Cho1

  • 1Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Antiviral Therapy
|June 21, 2018
PubMed
Abstract

Insights

Convalescent plasma (CP) infusion is a potential treatment for severe Middle East respiratory syndrome coronavirus (MERS-CoV). Donor plasma with a plaque reduction neutralization test (PRNT) titre of at least 1:80 is recommended for effective CP therapy.

Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Convalescent plasma (CP) infusion is explored as a treatment for severe Middle East respiratory syndrome coronavirus (MERS-CoV).
  • The efficacy of CP infusion for MERS-CoV has not been previously evaluated.
  • This study assesses serological responses in MERS patients receiving CP during the 2015 Korean MERS outbreak.

Observation:

  • Thirteen MERS patients with respiratory failure received CP infusions.
  • Only two of the three patients who received four CP infusions showed neutralizing activity.
  • Donor plasma with a PRNT titre of 1:80 showed a meaningful serological response post-infusion, unlike titres of 1:40.

Findings:

  • Enzyme-linked immunosorbent assay (ELISA) IgG predicted neutralization activity with high specificity.
  • An ELISA IgG cutoff optical density (OD) ratio of 1.6 showed >95% specificity for PRNT titres ≥1:80.
  • An ELISA IgG OD ratio of 1.9 demonstrated 100% specificity for PRNT titres ≥1:80.

Implications:

  • For effective MERS-CoV CP therapy, donor plasma should possess a PRNT titre of at least 1:80.
  • ELISA IgG testing can serve as a substitute for neutralization tests in resource-limited settings.
  • These findings guide the selection of effective CP for MERS treatment.

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