Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia

• Published in: Emerging Infectious Diseases
• Main Authors: Yaseen M. Arabi, Ali H. Hajeer, Thomas Luke, Kanakatte Raviprakash, Hanan Balkhy, Sameera Johani, Abdulaziz Al-Dawood, Saad Al-Qahtani, Awad Al-Omari, Fahad Al-Hameed, Frederick G. Hayden, Robert Fowler, Abderrezak Bouchama, Nahoko Shindo, Khalid Al-Khairy, Gail Carson, Yusri Taha, Musharaf Sadat, Mashail Alahmadi
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2016-09-01
• Subjects: Middle East respiratory syndrome coronavirus; MERS-CoV; Middle East respiratory syndrome; intensive care; convalescent plasma; high-titer convalescent plasma
• Online Access: https://wwwnc.cdc.gov/eid/article/22/9/15-1164_article

We explored the feasibility of collecting convalescent plasma for passive immunotherapy of Middle East respiratory syndrome coronavirus (MERS-CoV) infection by using ELISA to screen serum samples from 443 potential plasma donors: 196 patients with suspected or laboratory-confirmed MERS-CoV infection, 230 healthcare workers, and 17 household contacts exposed to MERS-CoV. ELISA-reactive samples were further tested by indirect fluorescent antibody and microneutralization assays. Of the 443 tested samples, 12 (2.7%) had a reactive ELISA result, and 9 of the 12 had reactive indirect fluorescent antibody and microneutralization assay titers. Undertaking clinical trials of convalescent plasma for passive immunotherapy of MERS-CoV infection may be feasible, but such trials would be challenging because of the small pool of potential donors with sufficiently high antibody titers. Alternative strategies to identify convalescent plasma donors with adequate antibody titers should be explored, including the sampling of serum from patients with more severe disease and sampling at earlier points during illness.