Antiphospholipid antibodies in convalescent plasma of donors recovered from mild COVID-19 infection

Background and Objectives: Passive immunization by the infusion of convalescent plasma (CP) obtained from patients who have recently recovered from COVID-19, thus having antibodies to severe acute respiratory syndrome coronavirus 2, is a potential strategy to reduce the severity of illness. A high prevalence of antiphospholipid antibodies (APLA) in patients with COVID-19 has been reported during the pandemic, raising a concern whether the use of CP could increase the risk of thrombosis in transfused patients. We aimed to evaluate the prevalence of APLA in COVID-19 CP (CCP) in order to assess the potential prothrombotic influence of transfused CCP to COVID-19 patients. Materials and Methods: We studied the prevalence of APLA in 122 CCP samples collected from healthy donors who recovered from mild-COVID-19 at two time periods: September 2020-January 2021 (defined as 'early period' samples) and April-May 2021 (defined as 'late period' samples). Thirty-four healthy subjects unexposed to COVID-19 were used as controls.Results APLA were present in 7 of 122 (6%) CCP samples. One donor had anti-beta 2-glycoprotein 1(anti-beta 2GP1) IgG, one had anti-beta 2GP1 IgM and five had lupus anticoagulant (LAC) using silica clotting time (SCT), all in 'late period' donors. In the control group, one subject had anti-beta 2GP1 IgG, two had LAC using dilute Russell viper venom time (dRVVT) and four had LAC SCT (both LAC SCT and LAC dRVVT in one subject). Conclusion: The low prevalence of APLA in CCP donors reassures the safety of CCP administration to patients with severe COVID-19.

Automated summary

This study aimed to evaluate the prevalence of antiphospholipid antibodies (APLA) in convalescent plasma (CP) obtained from COVID-19 patients and assess the potential risk of thrombosis in transfused patients. The results showed that out of 122 CP samples, 7 samples (6%) tested positive for APLA. The low prevalence of APLA in CP donors reassured the safety of CP administration to patients with severe COVID-19.