Red cell–bound antibodies and transfusion requirements in hospitalized patients with COVID-19

Berzuini, Alessandra; Bianco, Cristiana; Paccapelo, Cinzia; Bertolini, Francesco; Gregato, Giuliana; Cattaneo, A; Erba, Elisa; Bandera, Alessandra; Gori, Andrea; Lamorte, Giuseppe; Manunta, Maria; Porretti, Laura; Revelli, Nicoletta; Truglio, Francesca; Grasselli, Giacomo; Zanella, Alberto; Villa, Stefania; Valenti, Luca; Prati, Daniele

doi:10.1182/blood.2020006695

Cited by 87 publications

(86 citation statements)

References 11 publications

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“…As this study represents nationwide results rather than an analysis of hospitalized patients, blood demand in the entire COVID‐19 patient population, ranging from asymptomatic individuals to patients with severe symptoms, presented lower requirements of transfusion practice. A recent study by Berzuini et al revealed greater transfusion requirements in COVID‐19 patients with direct antiglobulin test (DAT) positivity compared to those with DAT‐negative results 4 . Although the authors suggested autoimmune haemolytic anaemia as the major underlying pathomechanism for RBC transfusion, our results indicate that the transfusion demand for RBC is higher than those for other blood components possibly due to anaemia during the COVID‐19 treatment period.…”

Section: Characteristics Total No Transfusion During Covid‐19 Treacontrasting

confidence: 67%

Transfusion demand in COVID‐19 patients from the Korean population: a nationwide study in South Korea

Rim¹,

Lee

Han

et al. 2020

Br J Haematol

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leukaemia (R/R AML) results were encouraging: 78Á6% of the overall response rate (ORR) (manuscript in preparation) without infusion-related toxicity. In this study, we saw unexpected favourable activity in subgroups of patients with central nervous system (CNS) leukaemia and with severe infection; in two of the latter, unsuspected pulmonary tuberculosis and aspergillosis were diagnosed as a NK cell infusion-emergent effect, with no hypoxia, and symptoms subsiding days after emergence. 14 In fact, none of our 14 DB-NK cell adoptive immunotherapies caused hypoxia, neither during DB-NK cell infusions nor later in their clinical course. RNA analysis of expanded DB-NK cells utilizing our manufactory platform revealed the absence of ACE-2 receptor (Dean A. Lee, personal communication). Lessons learned from the passive transfer of antibodies with convalescent plasma to treat infectious diseases indicate better results when the transfer is done earlier in the course of the disease. Convalescent plasma appears effective for SAR-CoV-2; however, it is becoming clear that severe patients already in the overwhelming cytokine storm and coagulopathy phase are less prone to have a benefit. 15 Since the idea is to establish an adaptive immune response as early as possible, and to that end, to attempt to overcome lung immune suppression by infusing highly activated DB-NK cells, it is our belief that NK cells should be infused early in the course of the disease since time to develop a robust immune adaptive response is the key point of the proposed therapy. Acknowledgement Dean Antony Lee, shared his NK cell expansion platform enabling us to develop it.

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Section: Characteristics Total No Transfusion During Covid‐19 Treacontrasting

confidence: 67%

Transfusion demand in COVID‐19 patients from the Korean population: a nationwide study in South Korea

Rim¹,

Lee

Han

et al. 2020

Br J Haematol

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“…Most patients exhibited isolated C4d on E deposition only. Using an anti C3d for checking direct antiglobulin test (DAT) positive COVID-19 patients A. Berzuini et al detected C3 in 12% only of their patients , confirming isolated C4d deposits only in many cases (Berzuini et al, 2020), as already observed on E in kidney transplant rejection (Golocheikine et al, 2010;Haidar et al, 2012), and SLE clinical flares (Manzi et al, 2004). The decrease of CR1/E density presented here, and the detection of virus spike, C3 or C4 fragment on E (Metthew Lam et al, 2020), among COVID-19 patients, are likely to be two aspects of the same phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Acquired decrease of the C3b /C4b receptor (CR1, CD35) and C4d deposits on Erythrocytes from ICU COVID-19 Patients

Kisserli

Schneider²,

Audonnet

et al. 2020

Preprint

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We determined CR1, CD35 the C3b, C4b receptor density, C3b/C3bi and C4d deposits densities on Erythrocytes (E) in 51 COVID-19 patients undergoing O2 therapy or assisted ventilation in ICU units in Rheims France. A clear acquired decrease of CR1 density of E from COVID-19 patients was observed, particularly among fatal cases, and paralleling several severity parameters. Deposits of C4d largely above values observed in normal individuals, mostly without C3 deposits, have been observed in more than 80% of the patients, reminiscent of the sub endothelial pericapil-lary deposits in organ transplant rejection, already observed on E in parallel, as well as also observed on E in clinical SLE flares. Conversely, significant C3 deposits were only observed among 1/4 of the patients. The decrease of CR1/E density, and the detection of virus spike, C3 or C4 fragment on E, among COVID-19 pa-tients, are likely to be two aspects of the same phenomenon of immune complexes or complement fragment coated cell debris handling and clearance. Measurement of C4d deposit on E might represent a way for assessing inflammation and comple-ment activation occurring in organ capillaries. CR1/E decrease might represent a cumulative index of complement activation in COVID-19 patients. Taken together, these original findings stress on the participation of the complement regulatory pro-teins in that disease and evidence that E matter in immune mechanisms in COVID-19 patients. The use of CR1, or CR1-like molecules with the aim of down regulating complement activation and inflammation for therapy should also be considered.

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“…It has been put forward that hospitalized COVID‐19 patients required fewer blood transfusions than other hospitalized patients [29] . Data from Italy showed that 39% of patients required transfusion (median duration of hospitalization of 15 days) for the main indication of anemia (non-bleeding), with very few patients requiring platelets or plasma [30] . If the hypothesis of an improvement in oxygen transport by transfusion has been put forward [31] , we did not find in our literature review any comparative study specifically looking at the role of treatment by increasing oxygen transport by blood transfusion in COVID-19 patients.…”

Section: Evaluation Of the Hypothesismentioning

confidence: 99%

Combating hypoxemia in COVID-19 patients with a natural oxygen carrier, HEMO2Life® (M101)

Lupon

Lellouch

Zal³

et al. 2021

Medical Hypotheses

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Red cell–bound antibodies and transfusion requirements in hospitalized patients with COVID-19

Cited by 87 publications

References 11 publications

Transfusion demand in COVID‐19 patients from the Korean population: a nationwide study in South Korea

Transfusion demand in COVID‐19 patients from the Korean population: a nationwide study in South Korea

Acquired decrease of the C3b /C4b receptor (CR1, CD35) and C4d deposits on Erythrocytes from ICU COVID-19 Patients

Combating hypoxemia in COVID-19 patients with a natural oxygen carrier, HEMO2Life® (M101)

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