Inflammatory markers and auto-Abs to type I IFNs in COVID-19 convalescent plasma cohort studyResearch in context

• Published in: EBioMedicine Vol. 87; p. 104414
• Main Authors: Fabrice Cognasse, Hind Hamzeh-Cognasse, Mickael Rosa, Delphine Corseaux, Brigitte Bonneaudeau, Chloe Pierre, Julie Huet, Charles Antoine Arthaud, Marie Ange Eyraud, Amélie Prier, Anne Claire Duchez, Theo Ebermeyer, Marco Heestermans, Estelle Audoux-Caire, Quentin Philippot, Tom Le Voyer, Olivier Hequet, Anne-Marie Fillet, Patricia Chavarin, Dominique Legrand, Pascale Richard, France Pirenne, Pierre Gallian, Jean Laurent Casanova, Sophie Susen, Pascal Morel, Karine Lacombe, Paul Bastard, Pierre Tiberghien
• Format: Journal Article
• Language: English
• Published: Elsevier 01.01.2023
• Subjects: Adverse events; Convalescent plasma; COVID-19; Endothelial cells; Inflammation; Transfusion
• ISSN: 2352-3964; 2352-3964

Background: 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. Methods: CCP (n = 766) was compared to non-convalescent control plasma (n = 166) for soluble inflammatory markers, ex-vivo inflammatory bioactivity on endothelial cells, neutralising auto-Abs to type I IFNs and reported adverse events in the recipients. Findings: CCP exhibited a statistically significant increase in IL-6 and TNF-alpha levels (0.531 ± 0.04 vs 0.271 ± 0.04; (95% confidence interval [CI], 0.07371–0.4446; p = 0.0061) and 0.900 ± 0.07 vs 0.283 ± 0.07 pg/mL; (95% [CI], 0.3097–0.9202; p = 0.0000829) and lower IL-10 (0.731 ± 0.07 vs 1.22 ± 0.19 pg/mL; (95% [CI], −0.8180 to −0.1633; p = 0.0034) levels than control plasma. Neutralising auto-Abs against type I IFNs were detected in 14/766 (1.8%) CCPs and were not associated with reported adverse events when transfused. Inflammatory markers and bioactivity in CCP with or without auto-Abs, or in CCP whether or not linked to adverse events in transfused patients, did not differ to a statistically significant extent. Interpretation: Overall, CCP exhibited moderately increased inflammatory markers compared to the control plasma with no discernible differences in ex-vivo bioactivity. Auto-Abs to type I IFNs detected in a small fraction of CCP were not associated with reported adverse events or differences in inflammatory markers. Additional studies, including careful clinical evaluation of patients treated with CCP, are required in order to further define the clinical relevance of these findings. Funding: French National Blood Service—EFS, the Association “Les Amis de Rémi” Savigneux, France, the “Fondation pour la Recherche Médicale (Medical Research Foundation)–REACTing 2020”.