Deployment of convalescent plasma for the prevention and treatment of COVID-19

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease , has spurred a global health crisis. To date, there are no proven options for prophylaxis for those who have been exposed to SARS-CoV-2, nor therapy for those who develop COVID-19. Immune (i.e. "convalescent") plasma refers to plasma that is collected from individuals, following resolution of infection and development of antibodies. Passive antibody administration through transfusion of convalescent plasma may offer the only short-term strategy to confer immediate immunity to susceptible individuals. There are numerous examples, where convalescent plasma has been used successfully as post-exposure prophylaxis and/or treatment of infectious diseases, including other outbreaks of coronaviruses (e.g. SARS-1, Middle East Respiratory Syndrome [MERS]). Convalescent plasma has also been used in the COVID-19 pandemic; limited data from China suggest clinical benefit, including radiological resolution, reduction in viral loads and improved survival. Globally, blood centers have robust infrastructure to undertake collections and construct inventories of convalescent plasma to meet the growing demand. Nonetheless, there are nuanced challenges, both regulatory and logistical, spanning donor eligibility, donor recruitment, collections and transfusion itself. Data from rigorously controlled clinical trials of convalescent plasma are also few, underscoring the need to evaluate its use objectively for a range of indications (e.g. prevention vs treatment) and patient populations (e.g. age, comorbid disease). We provide an overview of convalescent plasma, from evidence of benefit, regulatory considerations, logistical work flow and proposed clinical trials, as scale up is brought underway to mobilize this critical resource.

Protocol and Reagents for Pseudotyping Lentiviral Particles with SARS-CoV-2 Spike Protein for Neutralization Assays

“…Overall, we have described an easily accessible assay to study neutralizing antibody responses to SARS-CoV-2 in a biosafety-level-2 laboratory. This assay allows human sera or plasma samples to be screened in a convenient 96-well format, which will help facilitate the testing of large numbers of patient samples to better understand the development of immunity and to potentially screen donors for passive transfer of convalescent plasma [25,55].…”

The role of passive immunization in the age of SARS-CoV-2: an update

“…In a time of crisis, in which a therapy against a pathogen does not yet exist but this pathogen has triggered a pandemic crisis, every justifiable and documentable attempt must be made in order to achieve a therapeutic success with more than a low probability. This approach has now started in China and South Korea and case reports are available [3]. Meanwhile there a several publications, which show that the renaissance of passive immunization could be a bridging technology until effective medications or an active immunization is available.…”

A rapid, point of care red blood cell agglutination assay for detecting antibodies against SARS-CoV-2

“…38 The ability to rapidly screen donors for high titer antibodies against SARS-CoV-2 could facilitate the scaling of convalescent plasma donation. 39 Monitoring antibody development in patients may also help stratify COVID-19 patients and offer prognostic value for those who may clinically improve versus suffering respiratory demise.…”