Barrera Aldo, Martínez-Valdebenito Constanza, Nervi Bruno, Gaete-Argel Aracelly, Gálvez Nicolás M S, Osses Catalina, Vizcaya Cecilia, Ceballos María E, Pereira Jaime, Chang Mayling, Rojas Luis, Mondaca Sebastián, Henríquez Carolina, Kalergis Alexis M, Sette Alessandro, Grifoni Alba, Soto-Rifo Ricardo, Valiente-Echeverría Fernando, Ferres Marcela, Balcells María E, Corre Nicole Le
Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Red Salud UC-CHRISTUS, Laboratorio de Infectología y Virología Molecular, Santiago, Chile.
Curr Res Microb Sci. 2025 Jul 9;9:100440. doi: 10.1016/j.crmicr.2025.100440. eCollection 2025.
During the SARS-CoV-2 pandemic, the use of convalescent plasma (CP) in high-risk patients was proposed and widely implemented in several countries as a potential COVID-19 therapy. Nonetheless, CP therapy's impact on immune response is nowadays poorly understood, including the correlation between IgG levels, neutralization capacity, and cellular immune response against SARS-CoV-2. Here we evaluated, in a cohort of patients with COVID-19 requiring hospitalization and having received or not CP, as well as in CP donors (recovered from mild disease), the humoral and cellular immune response assessed by titers of SARS-CoV-2 IgG, neutralizing antibodies, and IFN-γ/IL-2 ELISpot during the first month (early) and up to nine months (long-term) after symptom onset. Results showed higher seropositivity and seroconversion rates between 7-12 days after plasma infusion in CP-recipients. However, similar IgG and neutralizing immune response kinetics between CP-recipients and non-recipients was observed during the first and until the ninth month of analysis. A positive correlation between IgG and neutralizing levels was detected. Compared to outpatient donors, hospitalized individuals showed a higher response at 3 and 6 months after symptoms onset. A sustained SARS-CoV-2-specific CD4 and CD8 T cell response was observed in outpatients and hospitalized patients, regardless of the CP treatment. We concluded that the CP infusion did not affect the long-term SARS-CoV-2 specific humoral and cellular immune responses. Nonetheless, CP may provide a therapeutic window by promoting a higher humoral response during the acute phase of COVID-19.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间，有人提议在高危患者中使用康复期血浆（CP），并在多个国家广泛实施，将其作为一种潜在的2019冠状病毒病（COVID-19）治疗方法。尽管如此，目前对CP疗法对免疫反应的影响了解甚少，包括免疫球蛋白G（IgG）水平、中和能力与针对SARS-CoV-2的细胞免疫反应之间的相关性。在此，我们评估了一组需要住院治疗且接受或未接受CP的COVID-19患者，以及CP捐献者（从轻症中康复），在症状出现后的第一个月（早期）直至九个月（长期）期间，通过SARS-CoV-2 IgG滴度、中和抗体以及干扰素-γ/白细胞介素-2酶联免疫斑点法（ELISpot）评估的体液免疫和细胞免疫反应。结果显示，CP接受者在血浆输注后7至12天之间的血清阳性率和血清转化率更高。然而，在分析的第一个月直至第九个月期间，观察到CP接受者和未接受者之间的IgG和中和免疫反应动力学相似。检测到IgG与中和水平之间呈正相关。与门诊捐献者相比，住院患者在症状出现后3个月和6个月时反应更高。无论是否接受CP治疗，门诊患者和住院患者均观察到持续的SARS-CoV-2特异性CD4和CD8 T细胞反应。我们得出结论，CP输注不影响长期的SARS-CoV-2特异性体液免疫和细胞免疫反应。尽管如此，CP可能通过在COVID-19急性期促进更高的体液反应提供一个治疗窗口期。
