DISCUSSION
death, inflammation, infections, primary SARS-CoV-2 infection, infection
SARS-COV-2 INFECTION, INFLAMMATION, INFECTIONS, INFECTION, PATHOGENESIS
In this study, we have firstly compared the serological metrics of CP used in REMAP-CAP and Argentinian trials, considering their markedly different outcomes. Whereas the REMAP-CAP trial could not demonstrate effectiveness of CP when administered to severely ill COVID-19 patients [As no differences in serological reactivity, nAb titers, or avidities in the plasma used in these 2 trials were observed in the present study (In terms of antibody maturation (low avidity, IgM positivity) the plasma used in REMAP-CAP and Argentinian trials was typical for endogenous antibodies produced during primary SARS-CoV-2 infection. Antibody-mediated SARS-CoV-2 uptake by monocytes and macrophages has been suggested to trigger inflammatory cell death leading to systemic inflammation that further modulates COVID-19 pathogenesis, but such antibody-mediated enhancement is not seen with vaccinee plasma [The therapeutic value of vaccine-derived CP is likely further enhanced by its previously described broadly neutralizing antibody response to new SARS-CoV-2 variants, including Omicron, which is important as such continue to emerge [However, enrolment of convalescent blood donors is now more laborious than in the beginning of the pandemic as SARS-CoV-2 infections are not currently that well recorded. It is also currently unknown to what extent the initial exposure, whether infection or vaccine, defines the antibody response that is later enhanced by booster vaccinations or infections (the original antigenic sin). While the present vaccine immunity is mostly against the original Wuhan strain, use of plasma of recently infected donors could better account for SARS-CoV-2 evolution whereas monoclonal antibodies or vaccines may need constant updating.In conclusion, we found no difference between CPs from REMAP-CAP or Argentina trials. As exemplified by the difference in the REMAP-CAP and Argentinian cohorts, simple antibody supplementation is clearly of greater value for patients prior to anti–SARS-CoV-2 seroconversion. Furthermore, plasma collected from convalescent donors following vaccination should be preferable for future CP treatment.