A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm

Intern Emerg Med. 2021 Nov;16(8):2181-2191. doi: 10.1007/s11739-021-02734-8. Epub 2021 Apr 10.

Abstract

Evaluating the effect of convalescent plasma (CP) on some cytokine storm indices in severe COVID-19 patients. Totally, 62 patients were randomly assigned into two groups for this clinical trial. Patients in the intervention group received one unit (500 mL) plasma on the admission day plus standard drugs while the controls merely received standard treatments. Eventually, primary and secondary outcomes were evaluated. In the CP group, compared with controls, the mean levels of lymphocytes and IL-10 significantly increased while the levels of IL-6, TNF-α, and IFN-γ decreased (p < 0.05). The length of in-hospital stay, and mortality rate did not significantly reduce in the CP group compared with controls (p > 0.05) while WHO severity scores remarkably improved (p = 0.01), despite the higher frequency of underlying diseases among the CP group (66.7%) vs. controls (33.3%). Although CP has a remarkable immunomodulatory and antiviral potential to improve the cytokine storm and disease severity in COVID-19 patients, it did not considerably affect the mortality rate.

Keywords: COVID-19; Convalescent plasma; Cytokine storm.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • B-Lymphocytes / metabolism
  • Blood Component Transfusion*
  • CD4-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / metabolism
  • COVID-19 / immunology
  • COVID-19 / therapy*
  • COVID-19 Serotherapy
  • Critical Illness / therapy
  • Cytokine Release Syndrome / immunology*
  • Cytokine Release Syndrome / therapy*
  • Female
  • Humans
  • Immunization, Passive
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Length of Stay
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Interleukin-6
  • Interleukin-10