Vaccine-Boosted CCP Decreases Virus Replication and Hastens Resolution of Infection Despite Transiently Enhancing Disease in SARS-CoV-2-Infected Hamsters

Timothy D Carroll; Talia Wong; Mary Kate Morris; Clara Di Germanio; Zhong-Min Ma; Mars Stone; Erin Ball; Linda Fritts; Arjun Rustagi; Graham Simmons; Michael Busch; Christopher J Miller

doi:10.1093/infdis/jiad568

Vaccine-Boosted CCP Decreases Virus Replication and Hastens Resolution of Infection Despite Transiently Enhancing Disease in SARS-CoV-2-Infected Hamsters

J Infect Dis. 2024 Jan 12:jiad568. doi: 10.1093/infdis/jiad568. Online ahead of print.

Authors

Timothy D Carroll^{1

2}, Talia Wong¹, Mary Kate Morris³, Clara Di Germanio⁴, Zhong-Min Ma², Mars Stone⁴, Erin Ball¹, Linda Fritts^{1

2}, Arjun Rustagi⁵, Graham Simmons⁴, Michael Busch⁴, Christopher J Miller^{1

2

6}

Affiliations

¹ Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
² California National Primate Research Center, University of California Davis, Davis, California, USA.
³ Division of Viral and Rickettsial Diseases, California Department of Public Health, Richmond, California, USA.
⁴ Vitalant Research Institute, San Francisco, California, USA.
⁵ Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
⁶ Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California, USA.

PMID: 38213276
DOI: 10.1093/infdis/jiad568

Abstract

Definitive data demonstrating the utility of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) for treating immunocompromised patients remains elusive. To better understand the mechanism of action of CCP, we studied viral replication and disease progression in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected hamsters treated with CCP obtained from recovered COVID-19 patients that were also vaccinated with an mRNA vaccine, hereafter referred to as Vaxplas. Vaxplas transiently enhanced disease severity and lung pathology in hamsters treated near peak viral replication due to immune complex and activated complement deposition in pulmonary endothelium, and recruitment of M1 proinflammatory macrophages into the lung parenchyma. However, aside from one report, transient enhanced disease has not been reported in CCP recipient patients, and the transient enhanced disease in Vaxplas hamsters may have been due to mismatched species IgG-FcR interactions, infusion timing, or other experimental factors. Despite transient disease enhancement, Vaxplas dramatically reduced virus replication in lungs and improved infection outcome in SARS-CoV-2-infected hamsters.

Keywords: COVID-19; animal models; immune plasma; transfusion.

Abstract

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