Convalescent Plasma Therapy in Patients With Severe or Life-Threatening COVID-19: A Metadata Analysis

Rabelo‐da‐Ponte, Francisco Diego; Silvello, Daiane; Scherer, Juliana Nichterwitz; Ayala, Alejandro; Klamt, Fábio

doi:10.1093/infdis/jiaa509

Cited by 15 publications

(14 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 174 A recent meta-analysis revealed that previous studies involving the transfusion of CP to patients with deadly Ebola, SARS-CoV-1, and H1N1 viruses improved patients’ immunity, suppressed the viral load, and reduced the duration of hospital stay and mortality with minimal side effects. 175 Nonetheless, the Indian Council of Medical Research published an open-label phase-2 multicenter randomized controlled trial (placid trial). Their research findings revealed that CP did not decrease COVID-19 severity and mortality rate.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

Abubakar¹,

Sani²,

Godman³

et al. 2020

IDR

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

Abubakar¹,

Sani²,

Godman³

et al. 2020

IDR

View full text Add to dashboard Cite

“…These efforts require a detailed understanding of immune correlates of protection, formation of immune memory, and durability of these responses. Additionally, infusion of plasma derived from COVID-19 recovered individuals is also being explored as a treatment strategy (12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Characterization of neutralizing versus binding antibodies and memory B cells in COVID-19 recovered individuals from India

Nayak¹,

Gottimukkala²,

Kumar³

et al. 2020

Preprint

View full text Add to dashboard Cite

India is one of the countries most affected by the recent COVID-19 pandemic. Characterization of humoral responses to SARS-CoV-2 infection, including immunoglobulin isotype usage, neutralizing activity and memory B cell generation, is necessary to provide critical insights on the formation of immune memory in Indian subjects. In this study, we evaluated SARS-CoV-2 receptor-binding domain (RBD)-specific IgG, IgM, and IgA antibody responses, neutralization of live virus, and RBD-specific memory B cell responses in pre-pandemic healthy versus convalescent COVID-19 individuals from India. We observed substantial heterogeneity in the formation of humoral and B cell memory post COVID-19 recovery. While a vast majority (38/42, 90.47%) of COVID-19 recovered individuals developed SARS-CoV-2 RBD-specific IgG responses, only half of them had appreciable neutralizing antibody titers. RBD-specific IgG titers correlated with these neutralizing antibody titers as well as with RBD-specific memory B cell frequencies. In contrast, IgG titers measured against SARS-CoV-2 whole virus preparation, which includes responses to additional viral proteins besides RBD, did not show robust correlation. Our results suggest that assessing RBD-specific IgG titers can serve as a surrogate assay to determine the neutralizing antibody response. These observations have timely implications for identifying potential plasma therapy donors based on RBD-specific IgG in resource-limited settings where routine performance of neutralization assays remains a challenge.ImportanceOur study provides an understanding of SARS-CoV-2-specific neutralizing antibodies, binding antibodies and memory B cells in COVID-19 convalescent subjects from India. Our study highlights that PCR-confirmed convalescent COVID-19 individuals develop SARS-CoV-2 RBD-specific IgG antibodies, which correlate strongly with their neutralizing antibody titers. RBD-specific IgG titers, thus, can serve as a valuable surrogate measurement for neutralizing antibody responses. These finding have timely significance for selection of appropriate individuals as donors for plasma intervention strategies, as well as determining vaccine efficacy.

show abstract

“…The insignificant effect of CP on the improvements of clinical COVID-19 symptoms is comparable to another systematic review and meta-analysis of 5 studies with a total of 259 patients with COVID-19, showing more clinically improved patients treated with CP than no CP treatment but was not statistically significant (OR 2.06, 95% CI 0.8-4.9; I 2 =44%) [208]. In contrast, the meta-analysis of 9 controlled and uncontrolled studies showed improved clinical status of patients with COVID-19 when compared to baseline (ROM 0.53, 95% CI 0.36-0.79; P<.01; n=149) [147].…”

Section: Main Findingsmentioning

confidence: 86%

“…In a particular correspondence, a metadata analysis of the efficacy of CP treatment based on 9 clinical studies (mostly case series) suggested that CP reduced viral loads (risk ratio 0.13, 95% CI 0.09-0.18; P<.001; n=75) and C-reactive protein levels (ratio of mean [ROM] 0.11, 95% CI 0.01-0.86; P<.05; n=42), and improved the clinical status of patients with COVID-19 (ROM 0.53, 95% CI 0.36-0.79; P<.01; n=149) when compared to baseline (date of CP transfusion) [147]. In addition, the effects of CP on C-reactive protein levels and clinical improvement were not associated with the patient's age and the use of antivirals, antibiotics, and hydroxychloroquine.…”

mentioning

confidence: 99%

Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis

Peng¹,

Rhind²,

Beckett³

2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

Background The COVID-19 pandemic, caused by a novel coronavirus termed SARS-CoV-2, has spread quickly worldwide. Convalescent plasma (CP) obtained from patients following recovery from COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle and in many clinical reports. Objective We seek to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitative analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. Methods PubMed, Web of Science, and Embase were continuously searched for studies assessing the use of CP for COVID-19, including clinical studies, commentaries, reviews, guidelines or protocols, and in vitro testing of CP antibodies. The screening process and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal of all clinical studies was conducted using a universal tool independent of study designs. A meta-analysis of case-control and randomized controlled trials (RCTs) was conducted using a random-effects model. Results Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, and 35 in vitro testing of CP antibodies matched the criteria. Positive results have been mostly observed so far when using CP for the treatment of COVID-19. There were remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, and time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies, in particular case reports and case series, had poor quality. Only 1 RCT was of high quality. Randomized and nonrandomized data were found in 2 and 11 studies, respectively, and were included for meta-analysis, suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. Conclusions There is developing support for CP therapy, particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in patients with COVID-19. Future research is necessary to fill the knowledge gap regarding prevention and treatment for patients with COVID-19 with CP while other therapeutics are being developed.

show abstract

Convalescent Plasma Therapy in Patients With Severe or Life-Threatening COVID-19: A Metadata Analysis

Cited by 15 publications

References 6 publications

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

Characterization of neutralizing versus binding antibodies and memory B cells in COVID-19 recovered individuals from India

Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis

Contact Info

Product

Resources

About