Phase I/II Clinical Trial of Autologous Activated Platelet-Rich Plasma (aaPRP) in the Treatment of Severe Coronavirus Disease 2019 (COVID-19) Patients

Abstract

Background. The outbreak of Coronavirus Disease 2019 (COVID-19) has been increasing rapidly. This disease causes an increase in proinflammatory cytokine production that leads to cytokine storm or cytokine release syndrome (CRS). Autologous activated platelet-rich plasma (aaPRP) contains various types of growth factors and anti-inflammatory cytokines that may have the potential to suppress CRS. This study of phase I/II trial was aimed to evaluate the safety and efficacy of aaPRP to treat severe COVID-19 patients. Methods. A total of 10 severe COVID-19 patients from Koja Regional Public Hospital (Koja RPH) were admitted to the intensive care unit (ICU). All patients received aaPRP administration three times. Primary outcomes involving the duration of hospitalization, oxygen needs, time of recovery, and mortality were observed. Secondary outcomes involving C-reactive protein (CRP), neutrophil, lymphocyte, and lymphocyte-to-CRP (LCR) and neutrophil-lymphocyte ratio (NLR) were analyzed. Results. All patients were transferred to the ICU with a median duration of 9 days. All patients received oxygen at enrollment and nine of ten patients recovered from the ICU and transferred to the ward room. There was one patient who passed away in the ICU due to heart failure. The results of secondary outcomes showed that CRP value and lymphocytes counts were significantly decreased while neutrophils, LCR, and NLR were slightly increased after aaPRP administration. Conclusions. Our results of the phase I/II trial demonstrated that the use of aaPRP in severe COVID-19 patients was safe and not associated with serious adverse events, which showed that aaPRP was a promising adjunctive therapy for severe COVID-19 patients.

Platelet-Released Factors: Their Role in Viral Disease and Applications for Extracellular Vesicle (EV) Therapy

“…PDGF, TGF-b, and VEGF play critical roles in tissue regeneration and wound healing; thus, it makes sense why PRP therapy has been found to be a successful treatment for chronic wounds [145][146][147]. Recently, PRP therapy has also been explored for the treatment of viral diseases, such as BK virus induced hemorrhagic cystitis, severe COVID-19, and for veterinary use in the treatment of ulcers caused by feline herpes virus-1 or canine herpes virus [148][149][150]. Another experimental platelet-based therapy is human platelet lysate (HPL), which involves the dissociation of platelet membranes to reveal various platelet factors, which has been used as an experimental therapy for COVID-19 [151][152][153][154].…”

Efficacy of Activated Autologous Platelet-Rich Plasma in The Treatment of Diabetic Foot Ulcers: An Evidence-Based Brief Literature Review

“…To improve outcomes in DFU care, several adjuvant therapies have been proposed, among which is activated autologous platelet-rich plasma (aaPRP). Advances in biotechnology has enabled scientists to uti-lize platelets for a wide array of uses, such as alopecia 4 , tendinopathy 5 , and even cytokine storm [6][7][8] . By processing blood samples from the patients, various bioactive proteins which possess favorable properties such as regeneration, can be released 3, 9 .…”

Effect of BIO-PLYTM, a Platelet-Rich Plasma Derived Biologic on PRRSV-2-Infected Macrophages

“…As one of the main complications of traumatic lesions is potential subsequent bacterial infections [29][30][31], the discovery of the antimicrobial capacities of PRP brought great advantages to its utilization, since the application of a single compound could aid with multiple complications at a time such as pain relief [18], immune regulation [24] and bacterial control [27,[32][33][34][35]. Recently, the antiviral properties of PRP have been described for SARS-CoV-2 [36,37], leading the way for PRP and its derivatives to be applied as safe and effective antivirals.…”