COVID-19 Convalescent Plasma Observational Study of Inflammatory Markers and Auto-Abs to Type I Interferon
COVID-19 convalescent plasma (CCP) contains neutralising anti-SARS-CoV-2 antibodies that may be useful as COVID-19 passive immunotherapy in patients at risk of developing severe disease. Such plasma from convalescent patients may also have additional immune-modulatory properties when transfused to COVID-19 patients. Fresh Frozen Plasma (FPP) has proved effective in correcting clotting factor deficiencies and is therefore frequently transfused in patients with active bleeding, as well as those with abnormal coagulation tests to prevent bleeding. However, FFP transfusion can be associated with adverse outcomes, including transfusion-related acute lung injury (TRALI) as well as transfusion-associated circulatory overload. An Inflammatory response, mediated at least in part by factors present in the transfused FPP, may contribute to plasma-related adverse events. A causal relationship between inflammation and transfusion-related adverse events has been clearly described in the platelet transfusion context. In comparison, the role of inflammation in ARs associated with FFP transfusion has been poorly explored to date. FFP cytokines and chemokine’s are powerful modulators of a broad spectrum of Immune responses, including inflammation. In addition to interfering with coagulation, such molecules promote a pro-coagulant state, which effectively maintains inflammation. Furthermore, when used as passive immunotherapy, the inflammatory content of CCP may interact with COVID-19 neutralising antibodies, which may be present in the plasma or already present in the recipient. In addition, auto-Abs against type I interferons (IFNs) were detected in severe cases of COVID-19 in at least 15% of previously healthy patients. This study therefore seeks to quantify soluble inflammatory molecules as well as bioactivity in CCP and compare it to Non-convalescent FFP. We also assessed the presence of auto-Abs to type I IFNs in CCP. Finally, we investigated whether the inflammatory characteristics of CCP differed in the presence or absence of auto-Abs or in CCP involved in transfusion-related adverse events.