Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review

Piechotta, Vanessa; Chai, Khai Li; Valk, Sarah J; Dorée, Carolyn; Monsef, Ina; Wood, Erica M.; Lamikanra, Abigail; Kimber, Catherine; McQuilten, Zoe; So‐Osman, Cynthia; Estcourt, Lise J; Skoetz, Nicole

doi:10.1002/14651858.cd013600.pub2

Cited by 288 publications

(251 citation statements)

References 134 publications

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“…Two ongoing trials of convalescent plasma in pregnant patients with COVID-19 disease are ongoing (NCT04397757 and NCT04388527) [ 40 , 41 ]. Documented adverse effects of convalescent plasma use in the general population are rare but include febrile and allergic transfusion reactions, transfusion-related acute lung injury (TRALI), and anaphylaxis [ 42 ]. Randomized trials of remdesivir use in COVID-19 have excluded pregnant and breastfeeding women, but the medication was used without documented harm in pregnant women during the Ebola and Marburg virus epidemics [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in pregnancy and the puerperium: A review for emergency physicians

Koyfman

Long

2021

The American Journal of Emergency Medicine

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Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel virus responsible for causing the novel coronavirus disease of 2019 (COVID-19). Objective This article discusses the clinical manifestations of COVID-19 in pregnant patients, the effects of pregnancy on the course of COVID-19 disease, and the impact of COVID-19 on pregnancy outcomes. Discussion The physiological and mechanical changes associated with pregnancy increase maternal susceptibility to infections and complicate intubation and mechanical ventilation. The most common symptoms of COVID-19 in pregnant patients are cough and fever, although many infected individuals are asymptomatic. The majority of pregnant women diagnosed with COVID-19 disease have a mild course of illness and will recover without needing to deliver, but the risk of critical illness and need for mechanical ventilation are increased compared to the general population. Risk factors for death and severe disease include obesity, diabetes, and maternal age > 40 years. Women in their third trimester have the highest risk for critical illness, intensive care unit admission, and need for mechanical ventilation. Adverse fetal outcomes of maternal COVID-19 infection include increased risk of miscarriage, prematurity, and fetal growth restriction. Vertical transmission of SARS-CoV-2 is possible but has not been conclusively proven. Conclusions COVID-19 is a potentially deadly infection, but data are limited concerning the pregnant population. Pregnant patients appear to present similarly to the general population, with fever and cough being the most reported symptoms in studies. Knowledge of these presentations and outcomes can assist clinicians caring for these patients.

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Section: Discussionmentioning

confidence: 99%

COVID-19 in pregnancy and the puerperium: A review for emergency physicians

Koyfman

Long

2021

The American Journal of Emergency Medicine

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“…34 Evidence for the role of convalescent plasma in reducing the duration and severity of SARS-CoV-2 infection is still evolving. 35 It is important to be mindful of the well established adverse side effects of these medications. Hydroxychloroquine and azithromycin independently increase risk of adverse cardiac events (eg, QTinterval prolongation, ventricular tachyarrhythmia and sudden cardiac death).…”

Section: Risks Of Unproven Medicationmentioning

confidence: 99%

Implications of COVID‐19 for an ageing population

Holt

Neumann

McNeil

et al. 2020

Medical Journal of Australia

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Implications of COVID-19 for an ageing population An evolving public health policy in response to the COVID-19 pandemic must address the needs of older people C oronavirus disease 2019 (COVID-19) encompasses a broad clinical spectrum caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Accumulating evidence indicates a strong age-related gradient for risk of severe disease, hospitalisation and death. A model-based analysis found that hospitalisation estimates for COVID-19 increased with age: 1.04% for people aged 20-29 years, increasing to 18.40% for those aged 80 years and older. 1 Applying these infection fatality rates (assuming a uniform attack rate by age group) to the Australian population, 2 we project that if 0.5 million Australians were infected with SARS-CoV-2, 66% of deaths would occur in those aged 70 years and older. Eighty-eight percent of deaths would occur in Australians aged 60 years and older (Box 1). The individual contributions related to frailty and physiological changes associated with ageing or multimorbidity remain uncertain. Given Australia's ageing population (21.4% are aged 60 years and older), 2 an evolving public health policy in response to the COVID-19 pandemic must address the needs of this vulnerable population. Key points regarding COVID-19 infection in older people are summarised in Box 2. Specific populations Health care workers account for an estimated 20% of positive cases in Italy, 3 14% in the United Kingdom, 4 and 11% in the United States. 5 In Australia in 2018, the average age of practising general practitioners and specialists was 51.1 and 49.9 years, respectively. 6 This creates complex challenges to strained health infrastructure and resources to ensure allocation of vulnerable staff to non-COVID-19-related roles while maintaining valuable clinical experience. Evidence for risk stratification for health care workers is currently lacking; specific occupational risk of SARS-CoV-2 infection and individual risk of morbidity and mortality (eg, age, medical comorbidities) must be assessed on a case-by-case basis.

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“…37 A Cochrane database review that included 20 studies (only one RCT) concluded that plasma therapy was of uncertain benefit. 38 Recently, itolizumab, an anti-CD6 IgG1 monoclonal antibody used for chronic plaque psoriasis, has been the first biologic to be approved by the Drug Controller General of India to treat CRS in moderate-to-severe COVID-19. However, there is little published data on this drug in COVID-19.…”

Section: Immunomodulatory Treatment In Covid-19mentioning

confidence: 99%

COVID-19 Pandemic in Women–Rheumatologist’s Perspective

Pinto

Roongta

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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COVID-19 has caused unprecedented challenges to every field. Rheumatic diseases (RD) are more common in women compared with men. Patients with RD are predisposed to infections both because of their disease and immunosuppressive medication. The severity of COVID-19 in women is less as compared with men among the general population. It is not known if the risk is higher in women with RD compared with other women. Currently, published data of COVID-19 in RD suggests similar or mildly increased risk in patients with RD but sex disaggregated data is not available. In this article, we review the current evidence of COVID-19 in RD with an emphasis on women.

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Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review

Abstract: Analysis 5.1. Comparison 5: Subgroup analysis: antibodies in recipients detected at baseline for the comparison of convalescent plasma versus placebo or standard care alone for individuals with moderate to severe disease, Outcome 1: All-cause mortality at up to day 28..

Cited by 288 publications

References 134 publications

COVID-19 in pregnancy and the puerperium: A review for emergency physicians

COVID-19 in pregnancy and the puerperium: A review for emergency physicians

Implications of COVID‐19 for an ageing population

COVID-19 Pandemic in Women–Rheumatologist’s Perspective

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