Coagulation Profile of Convalescent Plasma Donors and Recipients
Convalescent plasma (CP) therapy for COVID-19 infection may have favorable safety but varying efficacy, with concerns about its procoagulant impact. We investigated whether administration of CP to hospitalized patients affects their coagulation profile. Fifty-four patients randomized in a double-bli...
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SAGE Publishing
2025-01-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296251317522 |
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| author | Hanna H Pitkänen MD, PhD Tuukka Helin MD, PhD Tamim Khawaja MD Jukka-Pekka Pietilä MD Mikael Kajova MD Hanna Välimaa MD, PhD, DDS Tero Vahlberg MSc Jarkko Ihalainen MD Antti Vierikko MD Olli Vapalahti MD, PhD Anu Kantele MD, PhD Riitta Lassila MD, PhD |
| author_facet | Hanna H Pitkänen MD, PhD Tuukka Helin MD, PhD Tamim Khawaja MD Jukka-Pekka Pietilä MD Mikael Kajova MD Hanna Välimaa MD, PhD, DDS Tero Vahlberg MSc Jarkko Ihalainen MD Antti Vierikko MD Olli Vapalahti MD, PhD Anu Kantele MD, PhD Riitta Lassila MD, PhD |
| author_sort | Hanna H Pitkänen MD, PhD |
| collection | DOAJ |
| description | Convalescent plasma (CP) therapy for COVID-19 infection may have favorable safety but varying efficacy, with concerns about its procoagulant impact. We investigated whether administration of CP to hospitalized patients affects their coagulation profile. Fifty-four patients randomized in a double-blinded fashion received either placebo, low-titer CP (LCP) or high-titer CP (HCP). Donor blood samples were obtained at the time of the plasmapheresis, while recipient blood samples were collected before infusion, one day post-infusion and between two and six days after infusion. Routine laboratory follow-up, coagulation biomarkers, antiphospholipid antibodies, and thrombin generation (TG) were assessed. CP donors had normal blood cell counts and coagulation profiles, without differences between LCP and HCP donors at the baseline. All CP recipients were on low-molecular-weight heparin thromboprophylaxis at the time of the infusion. Despite randomization, the HCP group had lower baseline (p = 0.004) and Day 1 platelet counts (p = 0.019) than the LCP group. Von Willebrand antigen (VWF:Ag) levels clearly exceeded normal without differences at baseline. At Day 1, LCP recipients had higher VWF:Ag (mean ± SD 224 ± 15%) than HCP recipients (210 ± 8%) (p = 0.012). In all groups, overall 80% lupus anticoagulant was positive. Baseline TG variables were comparable, but again LCP recipients exhibited higher endogenous thrombin potential (ETP) (1313 ± 535 nM.min) (p = 0.038) and peak TG (184 ± 106 nM) (p = 0.037) than the HCP group (870 ± 425 nM.min and 86 ± 54 nM). Our findings show that LCP increases VWF:Ag levels and enhances TG despite the thromboprophylaxis. These results suggest that HCP induces less hypercoagulability than LCP, which may contribute to the variability in CP efficacy. |
| format | Article |
| id | doaj-art-a7e2b92400c44af4ab146940f85dbf8f |
| institution | Kabale University |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
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| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-a7e2b92400c44af4ab146940f85dbf8f2025-01-31T14:05:06ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-01-013110.1177/10760296251317522Coagulation Profile of Convalescent Plasma Donors and RecipientsHanna H Pitkänen MD, PhD0Tuukka Helin MD, PhD1Tamim Khawaja MD2Jukka-Pekka Pietilä MD3Mikael Kajova MD4Hanna Välimaa MD, PhD, DDS5Tero Vahlberg MSc6Jarkko Ihalainen MD7Antti Vierikko MD8Olli Vapalahti MD, PhD9Anu Kantele MD, PhD10Riitta Lassila MD, PhD11 Research Program in Systems Oncology, Faculty of Medicine, , Helsinki, Finland Department of Clinical Chemistry, HUS Diagnostic Centre, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland FIMAR, Multidisciplinary Center of Excellence in Antimicrobial Resistance Research, , Helsinki, Finland FIMAR, Multidisciplinary Center of Excellence in Antimicrobial Resistance Research, , Helsinki, Finland FIMAR, Multidisciplinary Center of Excellence in Antimicrobial Resistance Research, , Helsinki, Finland Department of Infectious Diseases, , Helsinki, Finland Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland , Vantaa, Finland , Helsinki, Finland Viral Zoonoses Research Unit, Departments of Virology and Veterinary Biosciences, University of Helsinki and Helsinki University Hospital Diagnostic Center, Helsinki, Finland FIMAR, Multidisciplinary Center of Excellence in Antimicrobial Resistance Research, , Helsinki, Finland Research Program in Systems Oncology, Faculty of Medicine, , Helsinki, FinlandConvalescent plasma (CP) therapy for COVID-19 infection may have favorable safety but varying efficacy, with concerns about its procoagulant impact. We investigated whether administration of CP to hospitalized patients affects their coagulation profile. Fifty-four patients randomized in a double-blinded fashion received either placebo, low-titer CP (LCP) or high-titer CP (HCP). Donor blood samples were obtained at the time of the plasmapheresis, while recipient blood samples were collected before infusion, one day post-infusion and between two and six days after infusion. Routine laboratory follow-up, coagulation biomarkers, antiphospholipid antibodies, and thrombin generation (TG) were assessed. CP donors had normal blood cell counts and coagulation profiles, without differences between LCP and HCP donors at the baseline. All CP recipients were on low-molecular-weight heparin thromboprophylaxis at the time of the infusion. Despite randomization, the HCP group had lower baseline (p = 0.004) and Day 1 platelet counts (p = 0.019) than the LCP group. Von Willebrand antigen (VWF:Ag) levels clearly exceeded normal without differences at baseline. At Day 1, LCP recipients had higher VWF:Ag (mean ± SD 224 ± 15%) than HCP recipients (210 ± 8%) (p = 0.012). In all groups, overall 80% lupus anticoagulant was positive. Baseline TG variables were comparable, but again LCP recipients exhibited higher endogenous thrombin potential (ETP) (1313 ± 535 nM.min) (p = 0.038) and peak TG (184 ± 106 nM) (p = 0.037) than the HCP group (870 ± 425 nM.min and 86 ± 54 nM). Our findings show that LCP increases VWF:Ag levels and enhances TG despite the thromboprophylaxis. These results suggest that HCP induces less hypercoagulability than LCP, which may contribute to the variability in CP efficacy.https://doi.org/10.1177/10760296251317522 |
| spellingShingle | Hanna H Pitkänen MD, PhD Tuukka Helin MD, PhD Tamim Khawaja MD Jukka-Pekka Pietilä MD Mikael Kajova MD Hanna Välimaa MD, PhD, DDS Tero Vahlberg MSc Jarkko Ihalainen MD Antti Vierikko MD Olli Vapalahti MD, PhD Anu Kantele MD, PhD Riitta Lassila MD, PhD Coagulation Profile of Convalescent Plasma Donors and Recipients Clinical and Applied Thrombosis/Hemostasis |
| title | Coagulation Profile of Convalescent Plasma Donors and Recipients |
| title_full | Coagulation Profile of Convalescent Plasma Donors and Recipients |
| title_fullStr | Coagulation Profile of Convalescent Plasma Donors and Recipients |
| title_full_unstemmed | Coagulation Profile of Convalescent Plasma Donors and Recipients |
| title_short | Coagulation Profile of Convalescent Plasma Donors and Recipients |
| title_sort | coagulation profile of convalescent plasma donors and recipients |
| url | https://doi.org/10.1177/10760296251317522 |
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