Convalescent plasma for COVID-19 in the intensive care unit

Abstract

Approximately 5-10% of coronavirus disease-19 (COVID-19) patients need intensive care and respiratory support [1] and, among those who develop pneumonia, 14% need oxygen therapy due to severe respiratory failure, and 5% need mechanical ventilation [2]. The disease severity increases in patients with comorbidities, especially advanced age and hypertension [3].Convalescent plasma therapy is classical adoptive immunotherapy. It has been used to treat SARS, MERS, and the 2009 H1N1 outbreak in the last two decades [4][5][6][7]. For this reason, it has been proposed as an adjunct treatment for COVID-19. It is thought that antibodies in the plasma obtained from recovered patients will reduce the virus load, thus limiting the severity of the disease [8].In April 2020, some early reports indicated that, in PCR-confirmed COVID-19, convalescent plasma may result in a decrease in oxygen demand within three days, a decrease in CRP levels, and an improvement in chest radiography within the first week [9,10]. However, in large-scale randomised con-