Post-transfusion activation of coagulation pathways during severe COVID-19 correlates with COVID-19 convalescent plasma antibody profiles.

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Tác giả: Judith A Aberg, Eric Acosta, Raymond A Alvarez, Suzanne A Arinsburg, Ian Baine, Paul Bastard, Nicole M Bouvier, Jean-Laurent Casanova, Benjamin K Chen, Ping Chen, Ralf Duerr, Adrian Gervais, Natalia L Komarova, Hung-Mo Lin, Sean Th Liu, Talia H Swartz, Ania Wajnberg, Svenja Weiss, Dominik Wodarz

Ngôn ngữ: eng

Ký hiệu phân loại: 152.1 Sensory perception

Thông tin xuất bản: United States : The Journal of clinical investigation , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 723380

Early antibody therapy can prevent severe SARS-CoV-2 infection (COVID-19). However, the effectiveness of COVID-19 convalescent plasma (CCP) therapy in treating severe COVID-19 remains inconclusive. To test a hypothesis that some CCP units are associated with a coagulopathy hazard in severe disease that offsets its benefits, we tracked 304 CCP units administered to 414 hospitalized COVID-19 patients to assess their association with the onset of unfavorable post-transfusion D-dimer trends. CCP recipients with increasing or persistently elevated D-dimer trajectories after transfusion experienced higher mortality than those whose D-dimer levels were persistently low or decreasing after transfusion. Within the CCP donor-recipient network, recipients with increasing or persistently high D-dimer trajectories were skewed toward association with a minority of CCP units. In in vitro assays, CCP from "higher-risk" units had higher cross-reactivity with the spike protein of human seasonal betacoronavirus OC43. "Higher-risk" CCP units also mediated greater Fcγ receptor IIa signaling against cells expressing SARS-CoV-2 spike compared with "lower-risk" units. This study finds that post-transfusion activation of coagulation pathways during severe COVID-19 is associated with specific CCP antibody profiles and supports a potential mechanism of immune complex-activated coagulopathy.
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