Early experience with convalescent plasma as immunotherapy for COVID‐19 in China: Knowns and unknowns

Abstract

Background and objectives In the absence of a vaccine or specific drug treatment options for coronavirus disease (COVID-19), attention has been shifted in China to the possible therapeutic use of convalescent plasma. COVID-19 convalescent plasma (CCP) is currently under investigation. We summarized clinical studies and other research data available as of 5 May 2020 on CCP therapy according to the Clinical Treatment Guideline of COVID-19 Convalescent Plasma in China, as well as clinical experience at the First Affiliated Hospital of Zhejiang University, as part of a comprehensive anti-epidemic strategy. Materials and methods As of 5 May 2020, when the epidemic was well-controlled in China, healthcare databases and sources of English literature relating to convalescent plasma were searched and reviewed. Sources of clinical and methodological heterogeneity were identified. Results As of 5 May 2020, up to 2000 samples of CCP had been collected across China and administered to 700 COVID-19 patients. From donors, 200-400 ml of plasma was collected at each donation, with antibody titres > 1:160. We identified three clinical studies for COVID-19 in China. Analyses showed a statistically significant improvement in clinical outcomes compared with untreated cases (P < 0.001). No adverse effects were reported. Conclusion From initial studies, convalescent plasma therapy appears effective and safe for COVID-19. However, there is clearly a need for well-designed RCTs (randomized controlled trials) or other formal studies to further evaluate the efficacy and any potential adverse effects of CCP.

Safety and efficacy of convalescent plasma therapy in severely and critically ill patients with COVID-19: a systematic review with meta-analysis

“…A review about CP therapy [ 40 ] reported that convalescent plasma treatment appeared effective and safe for COVID-19, but there was clearly a need for well-designed RCTs to further evaluate its efficacy and safety. A randomized trial [ 34 ] declared only 2 adverse events existed among 52 individuals with treatment of CP.…”

Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibodies in Egyptian Convalescent Plasma Donors

“…However, most protocols require that patients should be convalescent for 2-4 weeks prior to donation, that only adults donate, that routine procedures for accepting blood and blood products donations be followed, and that plasma is tested to quantitatively assess the levels of antibodies (Chen and Xia, 2020;Tiberghien, 2020). Antibody titer thresholds are also not standardized but a titer of 1:160 of SARS-CoV-2 specific IgG is recommended (Chen and Xia, 2020). The Egyptian public health authorities are testing the effectiveness of convalescent plasma therapy for COVID-19 patients.…”

Convalescent Plasma Therapy for COVID-19 still has the potential to save lives - The ICMR PLACID study dissected

“…Considering these facts, we believe that hospitalized patients with COVID-19 should continue to be offered the potential benefit of CPT -which has been proven to save lives in other trials. [11][12][13][14][15] 1. CPT for COVID-19 has been shown in clinical trials to reduce mortality of up to 30-50% in seriously ill COVID-19 patients 2.…”