key: cord-0908234-7t9jr2qk
authors: Fleming, Andrew B.; Raabe, Vanessa
title: Current studies of convalescent plasma therapy for COVID-19 may underestimate risk of antibody-dependent enhancement
date: 2020-04-28
journal: J Clin Virol
DOI: 10.1016/j.jcv.2020.104388
sha: af512f50cd5bcac3651cdab5266803608f990681
doc_id: 908234
cord_uid: 7t9jr2qk

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suggests that the role of antibodies in the pathogenesis of highly-pathogenic coronaviruses is complex. Rhesus macaques immunized with vaccines containing SARS-CoV spike protein who developed high neutralizing anti-spike titers prior to inoculation with SARS-CoV developed more severe acute lung injury (ALI) than non-immunized controls, despite having lower viral loads.

[2] One possible explanation for these findings is that antibodies help to shift the burden of infection into macrophages and other immune cells, a process which has been shown to occur in vitro. [3] SARS-CoV infection of macrophages may then lead to changes at the transcriptional level that potentiate the exuberant and dysregulated innate immune response that typifies ALI in SARS. [4] This 

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Neutralizing antibody response and SARS severity

Influence of FcgammaRIIA and MBL polymorphisms on severe acute respiratory syndrome