Efficacy and safety of convalescent plasma for severe COVID-19 based on evidence in other severe respiratory viral infections: a systematic review and meta-analysis

Abstract

Coronavirus disease 2019 (COVID-19) has been diagnosed in nearly 3 million individuals around the globe, of whom around 0.2 million have died. 1 Many patients with COVID-19 develop severe acute respiratory illness requiring admission to intensive care units (ICU) and often mechanical ventilation. 2 The case fatality rate in COVID-19 may be as high as 2.3% overall 2 and from 10% to 40% among severely affected individ uals. 3,4 There is an urgent need for effective therapies.Emerging epidemiologic and clinical data show both similarities and differences between severe COVID-19 and severe acute respiratory syndrome (SARS) and Middle East respiratory syn-drome (MERS). 5 Similarly, treatment strategies for severe influenza infections tested during the H1N1 pandemic and H5N1 and H7N9 outbreaks could inform the care of patients with severe COVID-19. 6 Of the treatment options proposed for COVID-19, 7 convalescent plasma has evidence suggesting a mortality benefit for Ebola virus infection. 8 This intervention has also been tested in other severe acute viral respiratory infections. 6,9,10 "Convalescent plasma" refers to plasma obtained from individuals recently recovered from a viral illness, which is expected to contain the highest levels of polyclonal antibodies directed against the RESEARCH Efficacy and safety of convalescent plasma for severe COVID-19 based on evidence in other severe respiratory viral infections: a systematic review and meta-analysis

Pulmonary fibrosis following infection with SARS-CoV-2 in a pregnant woman: case report

“…However, the plasma therapy has been not yet approved for use by United States Food and Drug Administration, and numerous clinical trials are working on it (14). In our study, the administration of convalescent plasma did not improve the clinical status of the patient, similar to the study of Niveditha that has demonstrated that convalescent plasma has few or no clinical bene t for the treatment of COVID-19 (15). Karuna and colleagues have proven that the presence of bilateral pleural effusion among patients infected with MERS indicates a poor prognosis such as death.…”

Convalescent plasma in the management of moderate COVID-19 in India: An open-label parallel-arm phase II multicentre randomized controlled trial (PLACID Trial)

“…[3][4][5] A recent systematic review on the use of CP in non-COVID-19 severe respiratory viral infections found no mortality benefit. 6 There is evidence that CP collected from COVID-19 survivors contains Receptor Binding Domain specific antibodies with potent antiviral activity. 7 However, effective titres of NAb, optimal timing for CP therapy, optimal timing for plasma donation, and the severity class of patients who are likely to benefit from CP therapy remains unclear.…”

SARS-CoV-2 neutralizing human antibodies protect against lower respiratory tract disease in a hamster model

“…Early during the outbreak, the usefulness of convalescent plasma transfusion was considered for treatment of severe cases 4 . Several large clinical trials have now been initiated to evaluate the efficacy and safety of convalescent plasma treatment of SARS-CoV-2 patients 5 .…”