COVID-19 convalescent plasma (CCP) is currently under investigation for both treatment and post-exposure prophylaxis. The active component of CCP mediating improved outcome is commonly reported as specific antibodies, particularly neutralizing antibodies, with clinical efficacy characterized according to the level or antibody affinity. In this review, we highlight the potential role of additional factors in CCP that can be either beneficial (e.g., AT-III, alpha-1 AT, ACE2+ extracellular vesicles) or detrimental (e.g., anti-ADAMTS13, anti-MDA5 or anti-interferon autoantibodies, pro-coagulant extracellular vesicles). Variations in these factors in CCP may contribute to varied outcomes in patients with COVID-19 and undergoing CCP therapy. We advise careful, retrospective investigation of such co-factors in randomized clinical trials that use fresh frozen plasma in control arms. Nevertheless, it might be difficult to establish a causal link between these components and outcome, given that CCP is generally safe and neutralizing antibody effects may predominate.
【저자키워드】 convalescent plasma, thrombosis, interferons, Extracellular vesicles, antithrombin III, ADAMTS13, MDA5, autoantibodies, controlled trials, decoy receptors, heterologous immunity, 【초록키워드】 COVID-19, Treatment, neutralizing antibody, randomized clinical trial, Neutralizing antibodies, outcome, Prophylaxis, Alpha, plasma, variations, randomized clinical trials, COVID-19 convalescent plasma, specific antibodies, retrospective, Clinical efficacy, detrimental, Safe, antibody affinity, CCP, frozen plasma, fresh frozen plasma, ARMS, Factor, component, causal link, CCP therapy, Effect, highlight, reported, characterized, contribute, patients with COVID-19, 【제목키워드】 COVID-19, review, narrative, Potential,