Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 224, Issue 4, Pages 565-574Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab010
Keywords
SARS-CoV-2; COVID-19; cytokine; convalescent plasma; hyperinflammation; hypoxia; acute respiratory distress syndrome
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Funding
- Council of Scientific Industrial Research (CSIR), India [MLP-129, MLP-2005]
- Foundation Botnar
- Department of Science and Technology, India (Swarnajayanti Fellowship)
- Science and Engineering Research Board, India (Ramanujan Fellowship)
- Department of Biotechnology, India (DBT)-Welcome Trust India Alliance
- DBT (Ramalingaswami Fellowship)
- CSIR
- University Grants Commission, India
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This study found that convalescent plasma therapy (CPT) has an anti-inflammatory role in COVID-19 patients beyond the presence of neutralizing antibodies. CPT can significantly reduce circulating interleukin-6 and interferon-gamma-inducible protein 10, leading to rapid alleviation of hypoxia.
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-gamma-inducible protein 10, contributed to marked rapid reductions in hypoxia in response to CPT.
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