THE EFFECTIVENESS OF ACB-IP 1.0 UNIVERSAL PATHOGEN FREE CONCENTRATED COCKTAIL CONVALESCENT PLASMA IN COVID-19 INFECTION
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Abstract
Introduction
The efficacy of SARS-CoV2 standard single donor convalescent plasma varied according to the application time and most importantly the amount of antibody that is administered. Single donor plasma has some drawbacks; such as the insufficient levels of neutralizing antibody activities, the requirements of blood group compatibility, and the risk of infection transmission. In this study, the efficacy and safety of pathogen inactivated, isohemagglutinin-depleted (concentrated) and pooled convalescent plasma was investigated.
Methods
In this study, ACB-IP 1.0 convalescent plasma product was prepared as follows; first, convalescent plasma was collected from different donors, then pathogen-inactivation was carried-out, and isohemagglutinins were cryodepleted, respectively. Finally, concentrated convalescent plasma product was pooled and stored until use.
A total of sixteen patients were treated with two different convalescent plasma products. Nine patients were treated with standard single donor convalescent plasma and seven were treated with pathogen-free, concentrated, pooled convalescent plasma (ACB-IP 1.0) between 01 April 2020 and 31 December 2020.
The outcomes of these two plasma products were compared regarding SARS-CoV2 antibody titers, neutralizing antibody activities, length of hospitalization and mortality rates.
Results
Five out of six single donor plasma SARS-CoV2 antibody titers remained below 12 s/co, but the antibody titers of all ACB-IP 1.0 plasma were above 12 s/co. SARS-CoV2 total antibody titers of ACB-IP 1.0 plasma were statistically higher than the antibody titers of single donor plasma. Mean total plasma neutralizing antibody activity of ACB-IP 1.0 plasma (1.5421) was found statistically higher than single donor plasma (0.9642) in 1:256 dilution (ρ=0.0087)
The mortality rate of the patients treated with ACB-IP 1.0 plasma showed statistically lower (p: 0,033) than the patients treated with single donor plasma. The administration of either single donor plasma or ACB-IP 1.0 plasma to the patients within eight days significantly shortened the length of hospitalization compared to administration of either plasma to the patients later than eight days (ρ= 0,0021)
Discussion
Pathogen-free, concentrated, pooled convalescent plasma may resolve the bias in SARS-CoV2 antibody titers and neutralizing antibody activities, without requiring blood group compatibility that allows patient accessibility in a shorter time and has safe plasma characteristic. This study indicates that ACB-IP 1.0 may be a superior product compared to standard single donor plasma.
(Patent Application No: PY2020-00232)
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SciScore for 10.1101/2021.03.05.21251413: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Written informed consent was obtained from all patients or their first degree relatives, and the trial was conducted under the principles stated in the Declaration of Helsinki and Good Clinical Practice guidelines and approval of Acibadem University ethics committee (Approval No: 2020-06/02) Clinical information of the groups was obtained from the hospital’s electronic medical records.
IRB: Written informed consent was obtained from all patients or their first degree relatives, and the trial was conducted under the principles stated in the Declaration of Helsinki and Good Clinical Practice guidelines and approval of Acibadem University ethics committee …SciScore for 10.1101/2021.03.05.21251413: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Written informed consent was obtained from all patients or their first degree relatives, and the trial was conducted under the principles stated in the Declaration of Helsinki and Good Clinical Practice guidelines and approval of Acibadem University ethics committee (Approval No: 2020-06/02) Clinical information of the groups was obtained from the hospital’s electronic medical records.
IRB: Written informed consent was obtained from all patients or their first degree relatives, and the trial was conducted under the principles stated in the Declaration of Helsinki and Good Clinical Practice guidelines and approval of Acibadem University ethics committee (Approval No: 2020-06/02) Clinical information of the groups was obtained from the hospital’s electronic medical records.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Cell Line Authentication not detected. Table 2: Resources
Experimental Models: Cell Lines Sentences Resources After one hour of incubation at room temperature, 10000 Vero cell/well is placed in a 96 Well Flat Bottom plate with 100 µl of complete DMEM (4% FBS + 1% PSA). Verosuggested: NoneSoftware and Algorithms Sentences Resources Endotoxin Analysis: The gel-clot technique is used for detecting or quantifying endotoxins (Division of Charles River Laboratories, Inc Lot: L4451L) Charles River Laboratoriessuggested: (Charles River Laboratories, RRID:SCR_003792)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Although the study has some limitations such as short follow-up time and small sample size, concluded that convalescent plasma may improve survival if given early onset of the disease. In the study conducted by Liu et al. 39 hospitalized patients with severe to life-threatening COVID-19, received convalescent plasma compared to a non-transfused control group. According to their results patients receiving convalescent plasma therapy had improved survival and supplementary oxygen requirements at Day 14 post-transfusion compared to non-transfused controls. Moreover, the authors recommend the transfusion of the convalescent plasma immediately after the hospitalization which supports the current study results.24 In a large retrospective study it was revealed that convalescent plasma treatment is a safe treatment option in COVID-19.25 These findings are in line with our results that either plasma products are safe in clinical usage. Conflicting with the above-mentioned studies, the beneficial effect of convalescent plasma could not be confirmed in SARS-CoV2 pneumonia patients in previous placebo-controlled trials.17, 26 The reason for the controversial result is explained with the lack of neutralizing antibody titer measurement of the donor plasma in the PLACID trial.17 Also, convalescent plasma was administered to the patients later than 3 days, contrary to what is recommended in the FDA report. FDA suggested in its report, that convalescent plasma transfusion can be effective wit...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04769245 Recruiting The Effectiveness of ACB-IP 1.0 Convalescent Plasma in COVID… Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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