Convalescent plasma for SARS-CoV-2 infection: win or learn

COVID-19; Convalescent plasmaCOVID-19; Plasma convalecienteCOVID-19; Plasma convalescentCurrent evidence does not support the use of convalescent plasma in the standard therapy for COVID-1

CURRENT ADVANCEMENTS ON THE EFFICACY OF CONVALESCENT PLASMA AS A POTENTIAL PROMISING TREATMENT FOR COVID-19

Purpose: No sooner had COVID-19 hit the world in December, 2019 in Wuhan, China, than the emergence of tremendous developments on the therapeutic interventions for the pandemic. No therapy has been proved successful up to date regardless potentiality of several intervention that are still in clinical trials. However Convalescent plasma demonstrated some sort of interest to be potential for the treatment of COVID-19 as we are still waiting for a specific therapy or vaccine. This review discusses current developments that supported the efficacy of convalescent plasma to attract its potentiality for treating COVID-19. Methods: A systematic search with a search term “efficacy of convalescent plasma on COVID-19” was done on PubMed, Google Scholar, Science direct, Research Gate and clinicaltrials.gov database. A search was conducted based on all the literature discussing the current advancements on the use of convalescent plasma as a potential treatment for coronavirus, however only studies that discussed its efficacy were retrieved in this review. Results: We retrieved a total of 24 articles discussing the current developments on the use of convalescent plasma as a potential treatment for COVID-19. 70% of the articles discuss its success, 20% of the articles evaluate current ongoing clinical trials for convalescent plasma while the remaining 10% present concerns on the inappropriate administration of convalescent plasma as a COVID-19 therapy. Conclusion: Several discussed studies demonstrated much attention on the use of convalescent plasma as a potential promising therapy for COVID-19, although this has not been proven. However, other studies expressed concerns over the inappropriate administration of the therapy where COVID-19 patients ended up developing a pro- thrombotic disease

Challenges faced by blood transfusion services in a tertiary care centre for recruitment of convalescent plasma donors for COVID-19

Background: The transfusion of convalescent blood products is an age old therapy in emerging infectious disease outbreaks. Convalescent plasma works on the principle of passive immunotherapy and Viral Neutralization. In the Current pandemic of corona virus disease (COVID-19), convalescent plasma transfusions can have therapeutic role as there is no specific preventative and therapeutic options. This study was done to see the challenges faced by blood transfusion services for recruitment of plasma donors.Methods: The retrospective study included challenges faced by blood transfusion services in recruiting Donors for convalescent plasma for COVID-19 and strategies followed for improving the donation at SMS Medical College and Hospital from April 2020 to October 2020.Results: This study evaluated challenges faced to recruit the recently recovered COVID-19 patients as donors, Setting up of plasmapheresis capacity, Role of social media in recruitment of Convalescent plasma donors, Financial aspects associated with Convalescent plasma donation, Role of NGOs in recruitment of donors and Success achieved in organization of donor mobilization and plasma collection.Conclusions: Recruitment of Convalescent Plasma donor from COVID-19 recovered patients is a big challenge for blood transfusion services. Different strategies to motivate donors should be implemented such as personnel communication, advertisement via classical mass media like radio, poster, newspaper and online media.

CONVALESCENT PLASMA THERAPY FOR COVID-19 PATIENTS: REGULATORY GUIDANCE ON COLLECTION, TESTING, PROCESSING, STORAGE, DISTRIBUTION, AND CLINICAL TRIALS

Convalescent plasma can be transfused to patients suffering from the same infection or for preparing immunoglobulin concentrates. Plasma obtained from recovered patients can be a valuable alternative during the COVID-19 pandemic for supporting its treatment within a randomized or case-control clinical trials or observational studies of plasma transfusion and for preparing plasma-derived biological products. WHO Blood Regulators Network highlighted that a systematic approach for collecting convalescent plasma from patients recovered from COVID-19 could provide a useful intervention. Structured clinical trials can be used to assess safety and effectiveness of convalescent plasma. The convalescent plasma therapy is still in the experimental stage and is currently not included in the interim clinical guidelines of WHO. However, an emergency investigational new drug application (eIND) process has been induced to ensure the availability of COVID-19 convalescent plasma to the patients with severe or life-threatening COVID-19 conditions. USFDA is regularly amending its guidance as new results, and best practices are emerging. The write-up provides an overview of convalescent plasma, from a regulatory considerations viewpoint, systematic workflow protocol, and a cross-section of clinical trials underway

Motivators for Convalescent Plasma Donors during the COVID-19 Pandemic

This study will seek to explore the motivators for convalescent plasma donors during the COVID-19 pandemic. In 2020, the global pandemic caused by SARS-CoV-2 increased donations of transfusion products, particularly convalescent plasma from COVID-19 survivors that is used to provide passive antibody immunity to those infected. Convalescent plasma therapy has been identified as one of the only therapies for COVID-19 beyond supportive care. Much of the current research focuses on the current motivators of whole blood and plasma donations, commonly citing altruistic motivations, knowing someone who has previously donated, and social media influence as common motivators for donations. It is important to explore not only what motivates COVID-19 survivors to initially donate plasma, but also the motivations of repeat donors. By gaining a greater understanding of what these motivators are, we may be able to convert these convalescent plasma donors to regular blood donors.https://scholarworks.uvm.edu/comphp_gallery/1308/thumbnail.jp

Coronavirus disease 2019 subphenotypes and differential treatment response to convalescent plasma in critically ill adults: secondary analyses of a randomized clinical trial

Purpose Benefit from convalescent plasma therapy for coronavirus disease 2019 (COVID-19) has been inconsistent in randomized clinical trials (RCTs) involving critically ill patients. As COVID-19 patients are immunologically heterogeneous, we hypothesized that immunologically similar COVID-19 subphenotypes may differ in their treatment responses to convalescent plasma and explain inconsistent findings between RCTs . Methods We tested this hypothesis in a substudy involving 1239 patients, by measuring 26 biomarkers (cytokines, chemokines, endothelial biomarkers) within the randomized, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia (REMAP-CAP) that assigned 2097 critically ill COVID-19 patients to either high-titer convalescent plasma or usual care. Primary outcome was organ support free days at 21 days (OSFD-21) . Results Unsupervised analyses identified three subphenotypes/endotypes. In contrast to the more homogeneous subphenotype-2 (N = 128 patients, 10.3%; with elevated type i and type ii effector immune responses) and subphenotype-3 (N = 241, 19.5%; with exaggerated inflammation), the subphenotype-1 had variable biomarker patterns (N = 870 patients, 70.2%). Subphenotypes-2, and -3 had worse outcomes, and subphenotype-1 had better outcomes with convalescent plasma therapy compared with usual care (median (IQR). OSFD-21 in convalescent plasma vs usual care was 0 (− 1, 21) vs 10 (− 1, to 21) in subphenotype-2; 1.5 (− 1, 21) vs 12 (− 1, to 21) in suphenotype-3, and 0 (− 1, 21) vs 0 (− 1, to 21) in subphenotype-1 (test for between-subphenotype differences in treatment effects p = 0.008). Conclusions We reported three COVID-19 subphenotypes, among critically ill adults, with differential treatment effects to ABO-compatible convalescent plasma therapy. Differences in subphenotype prevalence between RCT populations probably explain inconsistent results with COVID-19 immunotherapies

Motivators of and barriers to becoming a COVID-19 convalescent plasma donor: A survey study

Objectives: To determine the motivators and barriers to COVID-19 convalescent plasma donation by those in the United Kingdom who have been diagnosed with or who have had symptoms of SARS-CoV-2 (COVID-19) but who have not donated. Background: Convalescent plasma from people recovered from COVID-19 with sufficient antibody titres is a potential option for the treatment and prevention of COVID-19. However, to date, recruiting and retaining COVID-19 convalescent plasma donors has been challenging. Understanding why those eligible to donate COVID-19 convalescent plasma have not donated is critical to developing recruitment campaigns. Methods/Materials: A total of 419 UK residents who indicated that they had been infected with COVID-19 and who lived within 50 km of sites collecting COVID-19 convalescent plasma completed an online survey between 25th June and 5th July 2020. Respondents completed items assessing their awareness of convalescent plasma, motivations and barriers to donation and intention to donate COVID-19 convalescent plasma. Results: Awareness of COVID-19 convalescent plasma was low. Exploratory factor analysis identified six motivations and seven barriers to donating. A stronger sense of altruism through adversity and moral and civic duty were positively related to intention to donate, whereas generic donation fears was negatively related. Conclusions: Once potential donors are aware of convalescent plasma, interventions should focus on the gratitude and reciprocity that those eligible to donate feel, along with a focus on (potentially) helping family and norms of what people ought to do. Fears associated with donation should not be neglected, and strategies that have been successfully used tor recruit whole-blood donors should be adapted and deployed to recruit COVID-19 convalescent plasma donors

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

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), 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 for conferring immediate immunity to susceptible individuals. There are numerous examples in which convalescent plasma has been used successfully as postexposure 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 for undertaking collections and constructing 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, including evidence of benefit, regulatory considerations, logistical work flow, and proposed clinical trials, as scale-up is brought underway to mobilize this critical resource

Convalescent plasma for COVID-19 complicated by ARDS due to TRALI

© 2021 BMJ Publishing Group. All rights reserved. Convalescent plasma, which contains antibodies from recovered individuals, has been used as an effective treatment for infectious diseases in the past and is currently being used as a potential treatment option for COVID-19. Multiple studies have reported this treatment to be safe. We report a case of a patient who developed acute respiratory distress syndrome (ARDS) with features suggestive of transfusion-related acute lung injury after being treated with convalescent plasma for COVID-19. We emphasise the need to be aware of the potential risk of transfusion reactions and disease worsening with convalescent plasma administration and to weigh the risk and benefits of this therapy before administration to patients and propose that further study be done regarding the potential risks of convalescent plasma