Convalescent Plasma Transfusion for the Treatment of COVID-19 in Adults: A Global Perspective

Abstract

More than one year into the novel coronavirus disease 2019 (COVID-19) pandemic, healthcare systems across the world continue to be overwhelmed with soaring daily cases. The treatment spectrum primarily includes ventilation support augmented with repurposed drugs and/or convalescent plasma transfusion (CPT) from recovered COVID-19 patients. Despite vaccine variants being recently developed and administered in several countries, challenges in global supply chain logistics limit their timely availability to the wider world population, particularly in developing countries. Given the measured success of conventional CPT in treating several infections over the past decade, recent studies have reported its effectiveness in decreasing the duration and severity of COVID-19 symptoms. In this review, we conduct a literature search of published studies investigating the use of CPT to treat COVID-19 patients from January 2020 to January 2021. The literature search identified 181 records of which 39 were included in this review. A random-effects model was used to aggregate data across studies, and mortality rates of 17 vs. 32% were estimated for the CPT and control patient groups, respectively, with an odds ratio (OR) of 0.49. The findings indicate that CPT shows potential in reducing the severity and duration of COVID-19 symptoms. However, early intervention (preferably within 3 days), recruitment of donors, and plasma potency introduce major challenges for its scaled-up implementation. Given the low number of existing randomized clinical trials (RCTs, four with a total of 319 patients), unanticipated risks to CPT recipients are highlighted and discussed. Nevertheless, CPT remains a promising COVID-19 therapeutic option that merits internationally coordinated RCTs to achieve a scientific risk–benefit consensus.

Analysis of 52 240 source plasma donors of convalescent COVID‐19 plasma: Sex, ethnicity, and age association with initial antibody levels and rate of dissipation

“…On March 24, 2020, under an emergency access program, the Food and Drug Administration (FDA) issued an emergency use authorization for COVID-19 convalescent plasma (CCP) in critically ill patients with COVID-19 or those at high risk of severe disease. 12 Studies evaluating CCP have yielded heterogenous findings: some demonstrate an improvement in COVID-19 disease course, with a potential benefit being particularly evidenced when CCP is transfused early in disease course, [13][14][15][16] while others suggest little benefit of CCP in treatment of COVID-19. 3,[17][18][19][20][21][22][23] Early in the COVID-19 pandemic, CSL Plasma and several other companies joined efforts as the CoVIg-19 Plasma Alliance to collect CCP for development of a COVID-19 hyperimmune globulin product .…”

Clinical application of SARS-CoV-2 antibody detection and monoclonal antibody therapies against COVID-19

“…In clinical practice, a high titer CP with a volume of 200 mL can be considered first, and the need to increase the dose can be determined based on the individual patient scenario. Past and current studies have demonstrated real-world clinical efficacy for the treatment of COVID-19 with CP[ 34 - 36 ] This suggests that high-level randomized controlled trials (RCTs) should be designed in the future to investigate the potential therapeutic effects of CP in the treatment of COVID-19.…”

The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections

“…However, the various authorities agree that there is a need for a common approach and guidance across member states to the collection and use of CP for numerous infectious diseases [ 96 , 192 ]. In general, CP treatment has been increasingly adopted in clinical practice by most countries [ 193 ]. The FDA has approved the investigation of the efficacy of CP therapy for treating COVID-19 patients [ 194 ] and using convalescent plasma to treat COVID-19 [ 195 ].…”