Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience.
COVID-19
SARS-CoV-2
acute respiratory distress syndrome (ARDS)
convalescent plasma
flow cytometry
immunophenotype
Journal
Diagnosis (Berlin, Germany)
ISSN: 2194-802X
Titre abrégé: Diagnosis (Berl)
Pays: Germany
ID NLM: 101654734
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
received:
12
10
2022
accepted:
22
11
2022
medline:
16
5
2023
pubmed:
24
12
2022
entrez:
23
12
2022
Statut:
epublish
Résumé
Being COVID-19 convalescent plasma (CCP) a therapeutic option that can have a potential impact on the normalization of immunological parameters of COVID-19 affected patients, a detailed analysis of post-infusion immunological changes was conducted in CCP treated patients, aiming to identify possible predictive hallmarks of disease prognosis. This prospective observational study describes a cohort of 28 patients who received CCP shortly after being hospitalized for COVID-19 and diagnosed for Acute Respiratory Distress Syndrome. All patients were subjected to a detailed flow cytometry based evaluation of immunological markers at baseline and on days +3 and +7 after transfusion. At baseline almost all patients suffered from lymphopenia (25/28 on T-cells and 16/28 on B-cells) coupled with neutrophil-lymphocyte ratio exceeding normal values (26/28). Lymphocyte subsets were generally characterized by increased percentages of CD19+CD20-CD38hiCD27+ plasmablasts and reduction of CD4+CD45RA+CCR7+CD31+ recent thymic emigrants, while monocytes presented a limited expression of CD4 and HLA-DR molecules. Amelioration of immunological parameters began to be evident from day +3 and became more significant at day +7 post-CCP transfusion in 18 patients who recovered within 30 days from hospitalization. Conversely, baseline immunological characteristics generally persisted in ten critical patients who eventually progressed to death (6) or long-term care (4). This study demonstrates that proper immunophenotyping panels can be potentially useful for monitoring CCP treated patients from the first days after infusion in order to presume higher risk of medical complications.
Identifiants
pubmed: 36550685
pii: dx-2022-0112
doi: 10.1515/dx-2022-0112
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
193-199Informations de copyright
© 2022 Walter de Gruyter GmbH, Berlin/Boston.
Références
Mahase, E. Covid-19: WHO declares pandemic because of “alarming levels” of spread, severity, and inaction. BMJ 2020;368:m1036. https://doi.org/10.1136/bmj.m1036 .
doi: 10.1136/bmj.m1036
World Health Organization (WHO) . Coronavirus disease (COVID- 19 ); 2022. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 .
Coronavirus disease 2019 (COVID-19) treatment guidelines [Internet]. Bethesda, MD, US: National Institutes of Health; 2021. PMID: 34003615. Available from: https://pubmed.ncbi.nlm.nih.gov/34003615/ .
Sullivan, DJ, Gebo, KA, Shoham, S, Bloch, EM, Lau, B, Shenoy, AG, et al.. Early outpatient treatment for Covid-19 with convalescent plasma. N Engl J Med 2022;386:1700–11. https://doi.org/10.1056/NEJMoa2119657 .
doi: 10.1056/NEJMoa2119657
Franchini, M, Liumbruno, GM, Piacentini, G, Glingani, C, Zaffanello, M. The three pillars of COVID-19 convalescent plasma therapy. Life 2021;11:354. https://doi.org/10.3390/life11040354 .
doi: 10.3390/life11040354
Ripoll, JG, Van Helmond, N, Senefeld, JW, Wiggins, CC, Klassen, SA, Baker, SE, et al.. Convalescent plasma for infectious diseases: historical framework and use in COVID-19. Clin Microbiol Newsl 2021;43:23–32. https://doi.org/10.1016/j.clinmicnews.2021.02.001 .
doi: 10.1016/j.clinmicnews.2021.02.001
Focosi, D, Franchini, M, Pirofski, LA, Paneth, N, Joyner, MJ, Casadevall, A. COVID-19 convalescent plasma and randomized clinical trials: rebuilding confidence by explaining failures and finding signals of efficacy. Clin Microbiol Rev 2022;35:e00200-21. https://doi.org/10.1101/2021.09.07.21263194 .
doi: 10.1101/2021.09.07.21263194
Focosi, D, Franchini, M, Pirofski, LA, Burnouf, T, Fairweather, D, Joyner, MJ, et al.. COVID-19 convalescent plasma is more than neutralizing antibodies: a narrative review of potential beneficial and detrimental Co-factors. Viruses 2021;13:1594. https://doi.org/10.3390/v13081594 .
doi: 10.3390/v13081594
Shabbir, S, Raza, MH, Arshad, M, Khan, MJ. The interplay between the immune system and SARS-CoV-2 in COVID-19 patients. Arch Virol 2021;166:2109–17. https://doi.org/10.1007/s00705-021-05091-1 .
doi: 10.1007/s00705-021-05091-1
Sami, R, Fathi, F, Eskandari, N, Ahmadi, M, ArefNezhad, R, Motedayyen, H. Characterizing the immune responses of those who survived or succumbed to COVID-19: can immunological signatures predict outcome? Cytokine 2021;140:155439. https://doi.org/10.1016/j.cyto.2021.155439 .
doi: 10.1016/j.cyto.2021.155439
Franchini, M, Marano, G, Velati, C, Pati, I, Pupella, S, Maria Liumbruno, G. Operational protocol for donation of anti-COVID-19 convalescent plasma in Italy. Vox Sang 2021;116:136–7. https://doi.org/10.1111/vox.12940 .
doi: 10.1111/vox.12940
Perotti, C, Fante, CD, Baldanti, F, Franchini, M, Percivalle, E, Nepita, EV, et al.. Plasma from donors recovered from the new Coronavirus 2019 as therapy for critical patients with COVID-19 (COVID-19 plasma study): a multicentre study protocol. Intern Emerg Med 2020;15:819–24. https://doi.org/10.1007/s11739-020-02384-2 .
doi: 10.1007/s11739-020-02384-2
Perotti, C, Baldanti, F, Bruno, R, Fante, CD, Seminari, E, Casari, S, et al.. Mortality reduction in 46 severe Covid-19 patients treated with hyperimmune plasma. A proof of concept single arm multicenter trial. Haematologica 2020;105:2834–40. https://doi.org/10.3324/haematol.2020.261784 .
doi: 10.3324/haematol.2020.261784
Chiarini, M, Paghera, S, Moratto, D, Rossi, N, Giacomelli, M, Badolato, R, et al.. Immunologic characterization of a immunosuppressed multiple sclerosis patient that recovered from SARS-CoV-2 infection. J Neuroimmunol 2020;15:345: 577282. https://doi.org/10.1016/j.jneuroim.2020.577282 .
doi: 10.1016/j.jneuroim.2020.577282
Moratto, D, Chiarini, M, Giustini, V, Serana, F, Magro, P, Roccaro, AM, et al.. Flow cytometry identifies risk factors and dynamic changes in patients with COVID-19. J Clin Immunol 2020;40:970–3. https://doi.org/10.1007/s10875-020-00806-6 .
doi: 10.1007/s10875-020-00806-6