Lower anti‐spike levels in B‐cell‐depleted patients after convalescent plasma transfusion suggest the need for repeated doses.

Patients transfused with at least two CCP units (patients nos 1-4 and patients nos 7 and 8) cleared the virus faster (median 21 days vs 32 days) than patients receiving only one CCP unit (patients nos 5 and 6). Keywords: COVID-19 convalescent plasma; immunocompromised; neutralizing antibodies; rituximab EN COVID-19 convalescent plasma immunocompromised neutralizing antibodies rituximab e22 e24 3 01/16/23 20230115 NES 230115 We read with interest the recent paper by Gachoud et al., shedding light on plasma anti-spike immunoglobulin G (IgG) level kinetics in 36 immunocompromised COVID-19 patients (mostly unvaccinated and seronegative) transfused with plasma at the time of the alpha variant of concern (VOC).[1] Seventeen patients received four 200-ml units of convalescent plasma (CP) over 48 h, while 19 patients received two 200-ml units of two-dose mRNA vaccine plasma [either putatively COVID-19-naïve (VP) or COVID-19-experienced (CP/VP, a.k.a. "hybrid" plasma or VaxCCP)] over 24 h. The authors show that, in 17 patients previously treated with anti-CD20 monoclonal antibodies within the last 12 months, who represent a difficult-to-treat COVID-19 patient population, post-transfusion plasma anti-spike IgG levels are lower than in 19 untreated immunocompromised patients. [Extracted from the article]