Treatment of Influenza-Pneumonia by Use of Convalescent Human Serum

Redden, W. R.

doi:10.1056/nejm191912111812406

Cited by 14 publications

(9 citation statements)

References 3 publications

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“…After sifting 1449 unique records against the protocol eligibility criteria, we identified 32 studies from 50 reports ( Supplementary Table 1 ). Three studies could not be obtained [ 17–19 ], although results from a study by Bass et al [ 17 ] were reported elsewhere [ 20 ], which enabled their inclusion. French (n = 1), German (n = 2), and Korean (n = 2) records were screened by single reviewers because of a lack of multilingual collaborators.…”

Section: Resultsmentioning

confidence: 99%

“…Three systematic reviews met our protocol eligibility criteria [ 7 , 21 , 22 ]. Data on 1327 patients from 6 case studies [ 23–28 ], 20 case series [ 8 , 17 , 20 , 29–45 ], 2 case-comparison studies [ 46 , 47 ], and 1 prospective cohort [ 48 ] were included. We identified 13 observational studies published between 1918 and 1920, which studied 980 patients who received a clinical diagnosis of influenza-associated pneumonia or Spanish influenza A (H1N1) infection [ 17 , 20 , 33–35 , 38–44 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis

et al. 2014

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Background. Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence.Methods. Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria, using a 3-stage process. Data extraction and risk of bias assessments were undertaken.Results. We identified 32 studies of SARS coronavirus infection and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy (odds ratio, 0.25; 95% confidence interval, .14–.45; I2 = 0%). Studies were commonly of low or very low quality, lacked control groups, and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified.Conclusions. Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of Middle East respiratory syndrome coronavirus CoV infection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis

et al. 2014

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“…Most excluded studies (Appendix Table, available at www.annals.org) reported that use of influenza-convalescent blood products was beneficial (27)(28)(29)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). One large study at a U.S. Army recruit training hospital investigated the use of influenza-convalescent serum in patients with Spanish influenza but not pneumonia (27).…”

Section: Data From Excluded Studiesmentioning

confidence: 99%

“…No included study was identified solely from the citation review. We excluded 17 articles that were small case reports, were incomplete or noninterpretable, were written in a non-English language, or involved only patients with uncomplicated influenza (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). Tables 1 and 2 show details from these studies, which ranged in size from 43 to 551 patients.…”

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confidence: 99%

Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

et al. 2006

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Background: Studies from the Spanish influenza era reported that transfusion of influenza-convalescent human blood products reduced mortality in patients with influenza complicated by pneumonia. Treatments for H5N1 influenza are unsatisfactory, and convalescent human plasma containing H5N1 antibodies could be an effective therapy during outbreaks and pandemics.Purpose: To determine whether transfusion with influenza-convalescent human blood products reduced the risk for death in patients with Spanish influenza pneumonia.Data Sources: Manual search of English-language journals from 1918 to 1925. Citations from retrieved studies were also searched.Study Selection: Published English-language studies that had at least 10 patients in the treatment group, used convalescent blood products to treat Spanish influenza pneumonia in a hospital setting, and reported on a control or comparison group. Data Extraction:Two investigators independently extracted data on study characteristics, outcomes, adverse events, and quality. Data Synthesis: Eight relevant studies involving 1703 patients were found. Treated patients, who were often selected because of more severe illness, were compared with untreated controls with influenza pneumonia in the same hospital or ward. The overall crude case-fatality rate was 16% (54 of 336) among treated patients and 37% (452 of 1219) among controls. The range of absolute risk differences in mortality between the treatment and control groups was 8% to 26% (pooled risk difference, 21% [95% CI, 15% to 27%]). The overall crude case-fatality rate was 19% (28 of 148) among patients who received early treatment (after Ͻ4 days of pneumonia complications) and 59% (49 of 83) among patients who received late treatment (after Ն4 days of pneumonia complications). The range of absolute risk differences in mortality between the early treatment group and the late treatment group was 26% to 50% (pooled risk difference, 41% [CI, 29% to 54%]). Adverse effects included chill reactions and possible exacerbations of symptoms in a few patients.Limitations: Studies were few and had many methodologic limitations. No study was a blinded, randomized, or placebo-controlled trial. Some pertinent studies may have been missed. Conclusions:Patients with Spanish influenza pneumonia who received influenza-convalescent human blood products may have experienced a clinically important reduction in the risk for death. Convalescent human H5N1 plasma could be an effective, timely, and widely available treatment that should be studied in clinical trials.Ann Intern Med. 2006;145:599-609. www.annals.org For author affiliations, see end of text. The world is bracing for a potential H5N1 influenza pandemic. During the Spanish influenza pandemic, an estimated 30% of the world's population became ill and 50 million people died (1). An H5N1 influenza pandemic could be equally or more severe. Unfortunately, effective vaccines will be difficult to produce before a novel human pandemic strain emerges and will take substantial time to manufactur...

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“…The first use can be traced back between 1918 and 1920 during the Spanish Flu pandemic. 6 – 11 A meta-analysis was conducted by Luke et al regarding the effectiveness of CBP against Spanish influenza that involved eight studies and 1703 patients. 12 The study revealed significantly reduced mortality in CBP groups compared with untreated patients [16% versus 37% fatality; absolute risk difference 8% to 26%; pooled risk difference 21%, 95% confidence interval (CI): 15–27%].…”

Section: Convalescent Blood Productsmentioning

confidence: 99%

Convalescent Blood Products in COVID-19: A Narrative Review

Long

Sayed

Karki³

et al. 2020

Therapeutic Advances in Infection

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The coronavirus disease 2019 (COVID-19) pandemic has left the world in a state of desolation with overburdening public health systems in a short period. Finding possible preventative and therapeutic measures to counter severe respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has been the priority. A possible solution is convalescent blood products (CBP), primarily convalescent plasma (CP) and immunoglobulins, as an adjunctive therapy. CBP has been tried on the previous coronavirus epidemics with severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Therefore, we reviewed the clinical utility of CBP and available evidence in COVID-19. We found some of the current anecdotal studies demonstrate promising therapeutic potential, but many of these studies do not meet the academic rigours to substantiate its use with confidence. However, the compassionate use of CBP in critically ill COVID-19 patients can be an option while we await a definitive answer from ongoing randomised clinical trials.

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Treatment of Influenza-Pneumonia by Use of Convalescent Human Serum

Abstract: On September 28th, 1918, serum from convalescent influenzal pneumonia patients was used at my suggestion, in the treatment of this type of broncho-pneumonias at the Chelsea Naval Hospital on the service of Lt. Comm. MeGuire. The outcome in the treatment of 151

Cited by 14 publications

References 3 publications

The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis

The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis

Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

Convalescent Blood Products in COVID-19: A Narrative Review

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