Convalescent plasma as a treatment modality for Coronavirus Disease 2019 in Indonesia: A case reports

Abstract

Introduction and Importance: Coronavirus Disease 2019 (COVID-19) has become a pandemic since the beginning of 2020. COVID-19 is also spreading very rapidly in Indonesia and so far, no definitive therapy has been found. Case presentation We report two cases of confirmed COVID-19 with moderate pneumonia, who received 400 ml of convalescent plasma and showed improvements in clinical, laboratory and radiological examinations. Clinical discussion Passive immunotherapy is generally more effective when given early. Plasma transfusion is more beneficial when given before clinical conditions become severe. Some studies have shown that therapy with convalescent plasma can contribute to a longer survival and a lower length of stay. Conclusion Convalescent plasma can be used as an adjunctive therapy option for patients with moderate COVID-19.

Protective roles and protective mechanisms of neutralizing antibodies against SARS-CoV-2 infection and their potential clinical implications

“…Multiple studies have shown that passive antibody transfer has important implications for conferring a state of protective immunity in prophylactic or therapeutic settings ( 120 – 123 ). This involves the passive transfusion of recombinantly produced antibodies or antibodies from the plasma of convalescent patients to a non-immune person to provide immediate protection against severe SARS-CoV-2 infection ( 111 , 124 ).…”

“…According to a Chinese pilot investigation by Chen et al, transfusion of convalescent sera with NAb titers above 1:640 (in 200ml of plasma) is well tolerated and may improve patient outcomes through neutralizing viremia in severe COVID-19 cases ( 123 ). Whereas a case report from Indonesia recommends that the titer of SARS-CoV-2 NAb should be greater than 1:320 to effectively treat COVID-19 patients ( 120 ). Another recent randomized clinical trial also revealed that the use of high-titer convalescent plasma is beneficial in immunocompromised patients who have not yet had an antibody response ( 122 ).…”

“…Another recent randomized clinical trial also revealed that the use of high-titer convalescent plasma is beneficial in immunocompromised patients who have not yet had an antibody response ( 122 ). Convalescent plasma immunotherapy has been demonstrated to result in a longer survival time and a shorter hospital stay, especially when it is given early to COVID-19 patients ( 120 ). FDA has authorized convalescent plasma for emergency use in the treatment of hospitalized COVID-19 patients ( 139 ).…”