{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T01:59:30Z","timestamp":1785895170938,"version":"3.56.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with antibody deficiency respond poorly to coronavirus disease 2019 (COVID-19) vaccination and are at risk of severe or prolonged infection. They are given long-term immunoglobulin replacement therapy (IRT) prepared from healthy donor plasma to confer passive immunity against infection. Following widespread COVID-19 vaccination alongside natural exposure, we hypothesized that immunoglobulin preparations will now contain neutralizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antibodies, which confer protection against COVID-19 disease and may help to treat chronic infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We evaluated anti\u2013SARS-CoV-2 spike antibody in a cohort of patients before and after immunoglobulin infusion. Neutralizing capacity of patient samples and immunoglobulin products was assessed using in vitro pseudovirus and live-virus neutralization assays, the latter investigating multiple batches against current circulating Omicron variants. We describe the clinical course of 9 patients started on IRT during treatment of COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 35 individuals with antibody deficiency established on IRT, median anti-spike antibody titer increased from 2123 to 10 600 U\/mL postinfusion, with corresponding increase in pseudovirus neutralization titers to levels comparable to healthy donors. Testing immunoglobulin products directly in the live-virus assay confirmed neutralization, including of BQ1.1 and XBB variants, but with variation between immunoglobulin products and batches.<\/jats:p>\n                  <jats:p>Initiation of IRT alongside remdesivir in patients with antibody deficiency and prolonged COVID-19 infection (median 189 days, maximum &amp;gt;900 days with an ancestral viral strain) resulted in clearance of SARS-CoV-2 at a median of 20 days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Immunoglobulin preparations now contain neutralizing anti\u2013SARS-CoV-2 antibodies that are transmitted to patients and help to treat COVID-19 in individuals with failure of humoral immunity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad368","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T12:41:57Z","timestamp":1687005717000},"page":"950-960","source":"Crossref","is-referenced-by-count":35,"title":["Commercial Immunoglobulin Products Contain Neutralizing Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 Spike Protein"],"prefix":"10.1093","volume":"77","author":[{"given":"Vinit","family":"Upasani","sequence":"first","affiliation":[{"name":"Institute of Immunity and Transplantation, University College London (UCL) , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Townsend","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Royal Free London National Health Service (NHS) Foundation Trust , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Y","family":"Wu","sequence":"additional","affiliation":[{"name":"COVID Surveillance Unit, Francis Crick Institute , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J","family":"Carr","sequence":"additional","affiliation":[{"name":"Francis Crick Institute , London , United Kingdom"},{"name":"Department of Renal Medicine, Royal Free London NHS Foundation Trust , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Hobbs","sequence":"additional","affiliation":[{"name":"COVID Surveillance Unit, Francis Crick Institute , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Dowgier","sequence":"additional","affiliation":[{"name":"COVID Surveillance Unit, Francis Crick Institute , London , United 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