In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80–320). Their median age was 68 years (IQR, 56–78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (<68 years), mild disease (admission to low-intensity departments) and early treatment (<7 days from symptoms onset) with high nAb titer (≥320) CCP were found as independently associated with a favorable response to CCP treatment. No safety concerns were recorded, with a rate of CCP-related adverse reactions (all of mild intensity) of 1.3%. In our real-life experience, the first in the western world, early administration of high-titer CCP was a safe and effective treatment for hospitalized COVID-19 patients.

Background:The ABO blood group exerts a profound influence on hemostasis, and it has hence been associated with the development of thrombotic cardiovascular adverse events. In this study, we evaluated the relationship between the ABO blood group and the risk of cardiovascular disease assessed with the Cardiorisk score.Methods: All blood donors aged between 35 and 65 years were enrolled in the Cardiorisk program, which included the assessment of 8 variables (sex, age, total cholesterol, high-density lipoprotein (HDL) cholesterol, plasma glucose, arterial blood pressure, anti-hypertensive therapy and smoking) which were used to generate a score. Individuals with a resulting score ≥20, considered at high cardiovascular risk, underwent additional instrumental tests (chest X-ray, stress electrocardiogram and Doppler ultrasound of supra-aortic trunks) and were closely clinically monitored.Results: Between January 2005 and December 2015, 289 blood donors with Cardiorisk ≥20 were identified, 249 of whom were included in the study with at least 2 years of follow-up. Among these, 36 (14.5%) had instrumental abnormality tests and developed adverse cardiovascular events (10 acute coronary syndrome, 2 cerebral ischemia, 3 cardiac arrhythmia, 8 stenosis of supra-aortic trunks or iliac arteries) during a median follow-up of 5.3 years. In this group of 249 high risk individuals, a statistically significant association (P=0.02) was found between the non-O blood type and the risk of developing subclinical or clinical cardiovascular events (odds ratio, 3.3; 95% CI, 1.1-10.1; P=0.033). Conclusions:The results of this study underline the both key role of ABO blood group for the risk of developing arterial thrombotic events and the need for including such unmodifiable variable on the scores assessing the thrombotic risk.

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The primary goal in transfusion medicine and cellular therapies is to promote high standards of quality and produce ever safer and more efficacious products. The establishment of a transfusion service quality management system, which includes several organizational structures, responsibilities, policies, processes, procedures, and resources, is now mandatory and widely regulated worldwide. In this review, we summarize the current knowledge on the quality system in transfusion medicine as applied to the production of blood components, including red blood cells, platelets, and fresh frozen plasma.

Solvent/detergent-treated plasma was licensed >30 years ago. It has several specific characteristics, the most important being the standardized content of clotting factors, the lack of antibodies implicated in transfusion-related acute lung injury pathogenesis and the very high level of safety against transfusion-related viral infections. Since 1992, many clinical studies have confirmed its safety and efficacy in a wide range of congenital and acquired bleeding disorders. After a brief analysis of the pharmaceutical characteristics of solvent/detergent plasma, this review will focus on the clinical experience with this virus-inactivated plasma.