Evidence map›Paper›PMID 39432177›Full record

ArticleAnnals of intensive care2024

Immunological sub-phenotypes and response to convalescent plasma in COVID-19 induced ARDS: a secondary analysis of the CONFIDENT trial.

Benoît Misset, Anh Nguyet Diep, Axelle Bertrand, Michael Piagnerelli, Eric Hoste, Isabelle Michaux, Elisabeth De Waele, Alexander Dumoulin, Philippe G Jorens, Emmanuel van der Hauwaert and 11 more

Registry-linked trialAbstract read
In one paragraph

Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04558476 (A Multicenter Randomized Trial to Assess the Efficacy of CONvalescent Plasma Therapy in Patients With Invasive COVID-19 and Acute Respiratory Failure Treated With Mechanical Ventilation), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04558476 phase2completednot on this map

A Multicenter Randomized Trial to Assess the Efficacy of CONvalescent Plasma Therapy in Patients With Invasive COVID-19 and Acute Respiratory Failure Treated With Mechanical Ventilation: the CONFIDENT Trial

TypeinterventionalSponsorUniversity of LiegeRan2020 to 2023Enrolled475ConditionsCovid19, Mechanical Ventilation Complication, Corona Virus Infection, Respiratory FailureArmsConvalescent Plasma, Standard of Care
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Benoît MissetDepartment of Intensive Care Medicine, Liège University, CHU de Liège, Liege, Belgium. benoit.misset@chuliege.be.ORCID http://orcid.org/0000-0001-6466-0065
Anh Nguyet DiepBiostatistic Unit, Public Health Department, Liège University, Liege, Belgium.
Axelle BertrandDepartment of Intensive Care Medicine, Liège University, CHU de Liège, Liege, Belgium.
Michael PiagnerelliDepartment of Intensive Care Medicine, Marie-Curie University Hospital, Université Libre de Bruxelles, Charleroi, Belgium.
Eric HosteDepartment of Intensive Care Medicine, University Hospital, Ghent, Belgium.
Isabelle MichauxDepartment of Intensive Care, Université Catholique de Louvain, CHU UCL Namur, Yvoir, Belgium.
Elisabeth De WaeleDepartment of Clinical Nutrition, Vrije Universiteit Brussel Brussels University Hospital, Jette, Belgium.
Alexander DumoulinDepartment of Intensive Care Medicine, Delta General Hospital, Roeselare, Belgium.
Philippe G JorensDepartment of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp, LEMP, Edegem, Belgium.
Emmanuel van der HauwaertDepartment of Intensive Care Medicine, Imelda General Hospital, Bonheiden, Belgium.
Frédéric VallotDepartment of Intensive Care Medicine, Wallonie Picarde General Hospital, Tournai, Belgium.
Walter SwinnenDepartment of Intensive Care Medicine, Sint Blasius General Hospital, Dendermonde, Belgium.
Nicolas De SchryverDepartment of Intensive Care Medicine, Saint-Pierre Medical Clinic, Ottignies, Belgium.
Nathalie de MeyDepartment of Intensive Care Medicine, OLV General Hospital, Aalst, Belgium.
Nathalie LayiosDepartment of Intensive Care Medicine, Liège University, CHU de Liège, Liege, Belgium.
Jean-Baptiste MeslandDepartment of Intensive Care Medicine, Saint-Luc University Hospital, Brussels, Belgium.
Sébastien RobinetDepartment of Intensive Care Medicine, Liège University, CHU de Liège, Liege, Belgium.
Etienne CavalierDepartment of Clinical Chemistry, University of Liege, CIRM, CHU de Liège, Liege, Belgium.
Anne-Françoise DonneauBiostatistic Unit, Public Health Department, Liège University, Liege, Belgium.
Michel MoutschenDepartment of Infectious Diseases, CHU de Liège, Liege, Belgium.
Pierre-François LaterreDepartment of Intensive Care Medicine, Mons-Hainaut Regional Hospital, Mons, Belgium.

Funding

AXA Research Fund 1-0-1 AXABelgian Health Care Knowledge Centre KCE 2020Université de Liège Crédit classique facultaire
6 · The paper itself

Abstract

backgroundConvalescent plasma (CP) reduced the mortality in COVID-19 induced ARDS (C-ARDS) patients treated in the CONFIDENT trial. As patients are immunologically heterogeneous, we hypothesized that clusters may differ in their treatment responses to CP.

methodsWe measured 20 cytokines, chemokines and cell adhesion markers using a multiplex technique at the time of inclusion in the CONFIDENT trial in patients of centers having accepted to participate in this secondary study. We performed descriptive statistics, unsupervised hierarchical cluster analysis, and examined the association between the clusters and CP effect on day-28 mortality.

resultsOf the 475 patients included in CONFIDENT, 391 (82%) were sampled, and 196/391 (50.1%) had been assigned to CP. We identified four sub-phenotypes representing 89 (22.8%), 178 (45.5%), 38 (9.7%), and 86 (22.0%) patients. The most contributing biomarkers in the principal component analysis were IL-1β, IL-12p70, IL-6, IFN-α, IL-17A, IFN-γ, IL-13, TFN-α, total IgG, and CXCL10. Sub-phenotype-1 displayed a lower immune response, sub-phenotype-2 a higher adaptive response, sub-phenotype-3 the highest innate antiviral, pro and anti-inflammatory response, and adhesion molecule activation, and sub-phenotype-4 a higher pro and anti-inflammatory response, migration protein and adhesion molecule activation. Sub-phenotype-2 and sub-phenotype-4 had higher severity at the time of inclusion. The effect of CP treatment on mortality appeared higher than standard care in each sub-phenotype, without heterogeneity between sub-phenotypes (p = 0.97).

conclusionIn patients with C-ARDS, we identified 4 sub-phenotypes based on their immune response. These sub-phenotypes were associated with different clinical profiles. The response to CP was similar across the 4 sub-phenotypes.

trial registrationEthics Committee of the University Hospital of Liège CE 2020/239. CLINICALTRIALS: gov NCT04558476. Registered 2020-09-11, https://www. CLINICALTRIALS: gov/study/NCT04558476 .

Indexed as

ARDSConvalescent plasmaCOVID-19Immune responsePhenotypes

Identifiers

PMID39432177
PMCPMC11493925

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.