Convalescent plasma as potential therapy for severe COVID-19 pneumonia

Abstract

At the beginning of the COVID-19 pandemic, there was high mortality and a lack of effective treatment for critically ill patients. Build on the experience in argentine hemorrhagic fever with convalescent plasma, we incorporated 90 patients into a multicenter study, and 87 were evaluable. We collected 397 donations from 278 convalescent donors. Patients received plasma with an IgG concentration of 0.7-0.8 (measured by Abbott chemiluminescence) for every 10 kg of body weight. Survival during the first 28 days was the primary objective. 77% were male, age 54 (+/-15.6 y/o (range 27-85); body mass index 29.7 +/-; 4,4; hypertension 39% and diabetes 20%; 19.5% had an immunosuppression condition; 23% were healthcare workers. Plasma was administered to 55 patients (63%) on spontaneous breathing with oxygen supplementation (mainly oxygen mask with reservoir bag in 80%), and 32 patients (37%) were infused on mechanical ventilation. The 28-day survival rate was 80%, with 91% in patients infused on spontaneous breathing and 63% in those infused on mechanical ventilation (p = 0.0002). There was a significant improvement in the WHO pneumonia clinical scale at 7 and 14 days, and in PaO2 / FiO2, ferritin and LDH, in the week post-infusion. We observed an episode of circulatory volume overload and a febrile reaction, both mild. Convalescent plasma infusions are feasible, safe, and potentially effective, especially before requiring mechanical ventilation, and are an attractive clinical option for treating severe forms of COVID-19 until other effective therapies become available.

Convalescent plasma may be a possible treatment for COVID-19: A systematic review

“…Following removing duplicates and screening of titles and abstracts, we evaluated 153 articles in full text. Among these, we found 45 relevant articles (4RCTs, 11 controlled NRSIs, 7 non-controlled NRSIs and 23 case reports) [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] . Extracted details are presented in Table 1 (RCTs, controlled NRSIs, and non-controlled NRSIs) and table 2 (case report(series)).…”

“… The incidence of all serious AEs was low; these included transfusion reactions (n = 78; <1%), thromboembolic or thrombotic events (n = 113; <1%), and cardiac events (n = 677,~3%). Valentini et al [39] Argentina Open label trial, MC Intervention 87 Severe or critical 300–600 ml. Median of three days after hospital admission Index values ranged between 0 and 10 (mean 5.7) LPVr CPT are feasible, safe, and potentially effective, especially before requiring MV.…”

“…Mortality outcomes were reported in 21 of the included 22 controlled studies and non-controlled NRSIs [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [42] . The mortality outcome was evaluated from controlled studies: 4RCTs and 11NRSIs( Fig.…”

Effect of time and titer in convalescent plasma therapy for COVID-19

“…Upon identification of 753 univocal records, we selected 40 pertinent manuscripts. During the screening phase of these manuscripts, 15 were excluded: three studies did not report mortality data or compared mortality rate with national registries (Bradfute et al, 2020;Dulipsingh et al, 2020;Perotti et al, 2020); for two studies, we were unable to assess our inclusion criteria (Anakli et al, 2021;Skrip et al, 2020); seven had no comparative group (Dulipsingh et al, 2020;Gonzá lez et al, 2020;Jaiswal et al, 2021;Madariaga et al, 2020;Olivares-Gazca et al, 2020;Tremblay et al, 2020;Valentini et al, 2020); and three studies made use of plasma from non-convalescent, generic donors (De-Simone et al, 2021;Faqihi et al, 2020;Kamran et al, 2021). Of the 25 studies included for the quantitative meta-analysis, 10 were RCTs (Agarwal et al, 2020;AlQahtani et al, 2020;Avendano-Sola et al, 2020;Balcells et al, 2021;Gharbharan et al, 2020;Horby et al, 2021;Li et al, 2020a;Libster et al, 2021;Rasheed et al, 2020;Simonovich et al, 2020), while the other 15 were non-randomized studies with different designs (Abolghasemi et al, 2020;Alsharidah et al, 2021;Altuntas et al, 2021;Budhiraja et al, 2021;Donato et al, 2021;Duan et al, 2020;Hegerova et al, 2020;Joyner et al, 2021;Liu et al, 2020;Omrani et al, 2021;Salazar et al, 2020a;…”

Coronavirus Disease (COVID-19) Control between Drug Repurposing and Vaccination: A Comprehensive Overview

“…Based on previous experience with convalescent plasma in Argentine hemorrhagic fever, 90 patients were included in multicenter research, of which 87 were evaluable. A total of 278 convalescent donors contributed 397 donations [240]. Patients received plasma with an IgG content of 0.7-0.8 for every 10 kg of body weight.…”