<scp>COVID</scp>‐19 convalescent plasma: Interim recommendations from the <scp>AABB</scp>

Cohn, Claudia S.; Estcourt, Lise J; Grossman, Brenda J.; Pagano, Monica B.; Allen, Elizabeth S.; Bloch, Evan M.; Casadevall, Arturo; Devine, Dana V.; Dunbar, Nancy M.; Foroutan, Farid; Gniadek, Thomas J.; Goel, Ruchika; Gorlin, Jed B.; Joyner, Michael J.; Metcalf, Ryan A.; Raval, Jay S.; Rice, Todd W.; Shaz, Beth H.; Vassallo, Ralph R.; Winters, Jeffrey L.; Beaudoin, Gregory; Tobian, Aaron A.R.

doi:10.1111/trf.16328

Cited by 42 publications

(49 citation statements)

References 31 publications

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“…Joyner, Wright, et al, 2020). Interim guidelines for the American Association of Blood Banks (Cohn et al, 2021) and from Brazil (De Santis et al, 2021) emphasize both of these principles -early treatment and high antibody content in plasma. We hope that physicians policymakers, regulators and guideline committees consider the totality of the available evidence, including our findings, when making decisions for CCP use in individual patients (Casadevall, Joyner, & Paneth, 2021…”

Section: Discussionmentioning

confidence: 99%

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Casadevall

Dragotakes

Johnson

et al. 2021

eLife

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Background. The US Food and Drug Administration authorized Convalescent Plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the US.Methods. We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.Results. CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, P = 0.002) between CCP usage per hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.Conclusions. A strong inverse correlation between CCP use and mortality per admission in the USA provides population level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.Funding. There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.

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Section: Discussionmentioning

confidence: 99%

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Casadevall

Dragotakes

Johnson

et al. 2021

eLife

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“…In total, 18 EB-CPGs ( 14 – 16 , 18 , 20 , 21 , 24 – 26 , 34 , 37 , 39 , 40 , 42 , 45 , 47 , 50 , 51 ) and 7 CB-CPGs ( 22 , 23 , 28 , 32 , 38 , 41 , 46 ) provided suggestions on antivirals treatment for COVID-19. As shown in Table 4 , there were no consistent views on effective and validated antiviral drugs such as hydroxychloroquine/chloroquine plus azithromycin, lopinavir/ritonavir, convalescent plasma for the treatment in clinical scenarios.…”

Section: Resultsmentioning

confidence: 99%

Quality of and Recommendations for Relevant Clinical Practice Guidelines for COVID-19 Management: A Systematic Review and Critical Appraisal

et al. 2021

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Background: The morbidity and mortality of coronavirus disease 2019 (COVID-19) are still increasing. This study aimed to assess the quality of relevant COVID-19 clinical practice guidelines (CPGs) and to compare the similarities and differences between recommendations.Methods: A comprehensive search was conducted using electronic databases (PubMed, Embase, and Web of Science) and representative guidelines repositories from December 1, 2019, to August 11, 2020 (updated to April 5, 2021), to obtain eligible CPGs. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the quality of CPGs. Four authors extracted relevant information and completed data extraction forms. All data were analyzed using R version 3.6.0 software.Results: In total, 39 CPGs were identified and the quality was not encouragingly high. The median score (interquartile range, IQR) of every domain from AGREE II for evidence-based CPGs (EB-CPGs) versus (vs.) consensus-based CPG (CB-CPGs) was 81.94% (75.00–84.72) vs. 58.33% (52.78–68.06) in scope and purpose, 59.72% (38.89–75.00) vs. 36.11% (33.33–36.11) in stakeholder involvement, 64.58% (32.29–71.88) vs. 22.92% (16.67–26.56) in rigor of development, 75.00% (52.78–86.81) vs. 52.78% (50.00–63.89) in clarity of presentation, 40.63% (22.40–62.50) vs. 20.83% (13.54–25.00) in applicability, and 58.33% (50.00–100.00) vs. 50.00% (50.00–77.08) in editorial independence, respectively. The methodological quality of EB-CPGs were significantly superior to the CB-CPGs in the majority of domains (P < 0.05). There was no agreement on diagnosis criteria of COVID-19. But a few guidelines show Remdesivir may be beneficial for the patients, hydroxychloroquine +/– azithromycin may not, and there were more consistent suggestions regarding discharge management. For instance, after discharge, isolation management and health status monitoring may be continued.Conclusions: In general, the methodological quality of EB-CPGs is greater than CB-CPGs. However, it is still required to be further improved. Besides, the consistency of COVID-19 recommendations on topics such as diagnosis criteria is different. Of them, hydroxychloroquine +/– azithromycin may be not beneficial to treat patients with COVID-19, but remdesivir may be a favorable risk-benefit in severe COVID-19 infection; isolation management and health status monitoring after discharge may be still necessary. Chemoprophylaxis, including SARS-CoV 2 vaccines and antiviral drugs of COVID-19, still require more trials to confirm this.

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“…A matched propensity score study published by Salazar and colleagues found the greatest effect when patients were given CP within 44 h of hospital admission [24]. Thus, thanks to these and other similar studies [25], nowadays we are aware that CP must be administered early, possibly within 72 h from symptom onset [26]. Other RCTs [27,28] did not find clinical benefit from later CP administration.…”

Section: The Diseasementioning

confidence: 94%

“…The identification of the demographic and clinical characteristics of COVID-19 patients who could benefit most from CP is still a controversial issue and a matter of discussion among researchers. On a rational basis, CP should have it maximum efficacy in patients with an impaired humoral response against COVID-19 [26]. Indeed, there are several reports on CP clinical benefit in such patients, including those with solid and hematologic cancers and with acquired and congenital immune deficiencies [31].…”

Section: The Patientsmentioning

confidence: 99%

The Three Pillars of COVID-19 Convalescent Plasma Therapy

Franchini

Liumbruno

Piacentini

et al. 2021

Life

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The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread rapidly around the world in the last year causing the coronavirus disease 2019 (COVID-19), which still is a severe threat for public health. The therapeutic management of COVID-19 is challenging as, up until now, no specific and efficient pharmacological therapy has been validated. Translating the experience from previous viral epidemics, passive immunotherapy by means of plasma from individuals recovered from COVID-19 has been intensively investigated since the beginning of the pandemic. In this narrative review, we critically analyze the three factors, named “pillars”, that play a key role in determining the clinical effectiveness of this biologic therapy: the convalescent plasma, the disease (COVID-19), and the patients.

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COVID‐19 convalescent plasma: Interim recommendations from the AABB

Cited by 42 publications

References 31 publications

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Quality of and Recommendations for Relevant Clinical Practice Guidelines for COVID-19 Management: A Systematic Review and Critical Appraisal

The Three Pillars of COVID-19 Convalescent Plasma Therapy

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