Preparedness and activities of the anti-SARS-CoV-2 convalescent plasma bank in the Veneto region (Italy): An organizational model for future emergencies

Abstract

Background: Convalescent plasma (CP) has been used in the past in various pandemics, in particular in H1N1, SARS and MERS infections. In Spring 2020, when ongoing the SARS-CoV-2 pandemics, the Veneto Region (V-R) has proposed setting-up an anti-SARS-CoV-2 CP (CCP) Bank, with the aim of preparing a supply of CCP immediately available in case of subsequest epidemic waves. Materials and Methods: Key-points to be developed for a quick set-up of the V-R CCP Bank have been recruitment of donors recovered from COVID-19 infection, laboratory analysis for the biological qualification of the CCP units, including titre of neutralizing antibodies and reduction of pathogens, according to National Blood Centre (CNS) Directives, adaptation of the V-R Information Technology systems and cost analysis. Some activities, including diagnostic and viral inactivation processes, have been centralized in 2 or 3 sites. Laboratory analysis upon preliminary admission of the donor included all tests required by the Italian laws and the CNS directives. Results: From April to August 2020, 3,298 people have contacted the V-R Blood Transfusion Services: of these, 1,632 have been evaluated and examined as first time donors and those found to be suitable have carried out 955 donations, from which 2,626 therapeutic fractions have been obtained, at a cost around 215,00 Euro. Since October 2020, the number of COVID-19 inpatients has had a surge with a heavy hospital overload. Moreover, the high request of CCP therapy by clinicians has been just as unexpected, showing a wide therapeutic use. Conclusions:The organizational model here presented, which has allowed the rapid collection of a large amount of CCP, could be useful when facing new pandemic outbreaks, especially in low and middle income countries, with generally acceptable costs.

Outcome of SARS CoV-2 inpatients treated with convalescent plasma: One-year of data from the Veneto region (Italy) Registry

“…Italy has been the first Western country to be affected by the SARS-CoV-2 pandemic, after its appearance in China in December 2019. Veneto has been the first region in Italy to adopt on a regional scale a project for the collection of CCP throughout its territory [2] and to consider the use of this blood-derived product as a potential treatment option, in addition to any other therapy, none unfortunately targeting such a new viral infection.…”

“…As previously described [2] , all CCP collected units have been tested for determination and titration of anti-SARS-CoV-2 neutralizing antibodies by a microneutralization assay. Neutralizing antibody levels have been also determined at the first visit, and donors with a titre of ≥ 1:80 have been admitted to the CCP donation.…”

“…Convalescent plasma (CP) has been used worldwide to counteract the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) [1] . Since April 2020, it has also been utilised in the treatment of patients with COVID-19 in the Veneto region (Italy), along with all the other available drugs and therapeutic tools [2] .…”

“…In fact, CCP, as well as other therapeutic tools, has been made available according to clear-cut clinical criteria, in all hospitals of the Veneto region. The large-scale use of CCP has made possible owing to the establishment of the CCP Blood Bank promoted by the Regional Government [2] .…”

The future of blood services amid a tight balance between the supply and demand of blood products: Perspectives from the ISBT Young Professional Council

“…The SARS-CoV-2 pandemic has emphasized the importance of contingency plans to offer CP amid a major crisis [36]. In response to the SARS-CoV-2 pandemic, many blood services worldwide established a CP collection program that included protocols on how to recruit CP donors [37,38]. Although CP proved relatively inefficacious for SARS-CoV-2 [6], blood services may build on these experiences for rapid CP collection.…”