Nature and Dimensions of Systemic Hyperinflammation and its Attenuation by Convalescent Plasma in Severe COVID-19.
Adult
Anti-Inflammatory Agents
/ therapeutic use
Antibodies, Neutralizing
/ immunology
COVID-19
/ epidemiology
Cytokines
/ blood
Female
Humans
Immunization, Passive
/ methods
India
/ epidemiology
Male
Middle Aged
Plasma
RNA, Viral
/ isolation & purification
Respiratory Distress Syndrome
/ drug therapy
SARS-CoV-2
/ immunology
Viral Load
COVID-19 Drug Treatment
COVID-19 Serotherapy
COVID-19
SARS-CoV-2
acute respiratory distress syndrome
convalescent plasma
cytokine
hyperinflammation
hypoxia
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
16 08 2021
16 08 2021
Historique:
received:
03
11
2020
accepted:
11
01
2021
entrez:
16
8
2021
pubmed:
17
8
2021
medline:
26
8
2021
Statut:
ppublish
Résumé
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has led to significant morbidity and mortality. While most suffer from mild symptoms, some patients progress to severe disease with acute respiratory distress syndrome (ARDS) and associated systemic hyperinflammation. First, to characterize key cytokines and their dynamics in this hyperinflammatory condition, we assessed abundance and correlative expression of a panel of 48 cytokines in patients progressing to ARDS as compared to patients with mild disease. Then, in an ongoing randomized controlled trial of convalescent plasma therapy (CPT), we analyzed rapid effects of CPT on the systemic cytokine dynamics as a correlate for the level of hypoxia experienced by the patients. We identified an anti-inflammatory role of CPT independent of its neutralizing antibody content. Neutralizing antibodies, as well as reductions in circulating interleukin-6 and interferon-γ-inducible protein 10, contributed to marked rapid reductions in hypoxia in response to CPT. CTRI/2020/05/025209. http://www.ctri.nic.in/.
Sections du résumé
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has led to significant morbidity and mortality. While most suffer from mild symptoms, some patients progress to severe disease with acute respiratory distress syndrome (ARDS) and associated systemic hyperinflammation.
METHODS
First, to characterize key cytokines and their dynamics in this hyperinflammatory condition, we assessed abundance and correlative expression of a panel of 48 cytokines in patients progressing to ARDS as compared to patients with mild disease. Then, in an ongoing randomized controlled trial of convalescent plasma therapy (CPT), we analyzed rapid effects of CPT on the systemic cytokine dynamics as a correlate for the level of hypoxia experienced by the patients.
RESULTS
We identified an anti-inflammatory role of CPT independent of its neutralizing antibody content.
CONCLUSIONS
Neutralizing antibodies, as well as reductions in circulating interleukin-6 and interferon-γ-inducible protein 10, contributed to marked rapid reductions in hypoxia in response to CPT.
CLINICAL TRIAL REGISTRY OF INDIA
CTRI/2020/05/025209. http://www.ctri.nic.in/.
Identifiants
pubmed: 34398242
pii: 6089119
doi: 10.1093/infdis/jiab010
pmc: PMC7928875
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Antibodies, Neutralizing
0
Cytokines
0
RNA, Viral
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
565-574Subventions
Organisme : Council of Scientific Industrial Research
ID : MLP-129
Organisme : Department of Science and Technology, India
Organisme : Science and Engineering Research Board
Organisme : University Grants Commission, India
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.