Mortality in individuals treated with COVID-19 convalescent plasma varies with the geographic provenance of donors

Katie L. Kunze, Patrick W. Johnson, Noud van Helmond, Jonathon W. Senefeld, Molly M. Petersen, Stephen A. Klassen, Chad C. Wiggins, Allan M. Klompas, Katelyn A. Bruno, John R. Mills, Elitza S. Theel, Matthew R. Buras, Michael A. Golafshar, Matthew A. Sexton, Juan C. Diaz Soto, Sarah E. Baker, John R.A. Shepherd, Nicole C. Verdun, Peter Marks, Nigel S. PanethDe Lisa Fairweather, R. Scott Wright, Camille M. van Buskirk, Jeffrey L. Winters, James R. Stubbs, Katherine A. Senese, Michaela C. Pletsch, Zachary A. Buchholtz, Robert F. Rea, Vitaly Herasevich, Emily R. Whelan, Andrew J. Clayburn, Kathryn F. Larson, Juan G. Ripoll, Kylie J. Andersen, Elizabeth R. Lesser, Matthew N.P. Vogt, Joshua J. Dennis, Riley J. Regimbal, Philippe R. Bauer, Janis E. Blair, Arturo Casadevall, Rickey E. Carter, Michael J. Joyner

Research output: Contribution to journalArticlepeer-review


Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that immunological differences may impact the effectiveness of antibody-based treatments such as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma likely reflects the antigenic composition of local viral strains, we hypothesize that convalescent plasma has a higher efficacy, as defined by death within 30 days of transfusion, when the convalescent plasma donor and treated patient were in close geographic proximity. Results of a series of modeling techniques applied to approximately 28,000 patients from the Expanded Access to Convalescent Plasma program ( number: NCT04338360) support this hypothesis. This work has implications for the interpretation of clinical studies, the ability to develop effective COVID-19 treatments, and, potentially, for the effectiveness of COVID-19 vaccines as additional locally-evolving variants continue to emerge.

Original languageEnglish (US)
Article number4864
JournalNature communications
Issue number1
StatePublished - Dec 1 2021

ASJC Scopus subject areas

  • General Chemistry
  • General Biochemistry, Genetics and Molecular Biology
  • General Physics and Astronomy


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