Convalescent plasma: Alternative or promising therapy?
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ABSTRACT:
SUBMITTER: Mina FB
PROVIDER: S-EPMC7831955 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The world is passing through a very difficult phase due to the coronavirus disease 2019 (COVID-19) pandemic, which has disrupted almost all spheres of life. Globally, according to the latest World Health Organization report (10 August 2020), COVID-19 has affected nearly 20 million lives, causing 728 013 deaths. Due to the lack of specific therapeutic drugs and vaccines, the outbreak of disease has spawned a corpus of contagious infection all over the world, day by day, without control. As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a very rapid infection rate, it is essential to develop a novel ameliorative and curative strategy as quickly as possible. Convalescent plasma (CP) therapy is a type of adaptive immunity that has already been found to be effective in confronting several infectious diseases from the last two decades. For example, CP therapy was used in the treatment of viral-induced diseases like SARS-CoV epidemics, Middle East respiratory syndrome coronavirus (MERS-CoV) pandemics, Ebola epidemics and H1N1 pandemic. In this review, we have mainly focused on the therapeutic role of CP therapy and its neutralizing effect to fight against the COVID-19 outbreak.
| S-EPMC7536086 | biostudies-literature
Project description:While there is no proven treatment available for coronavirus disease 2019 (COVID-19), convalescent plasma (CP) may provide therapeutic relief as the number of cases escalate steeply world-wide. At the time of writing this review, vaccines, monoclonal antibodies or drugs are still lacking for the recent large COVID-19 outbreak, which restores the interest in CP as an empirical life-saving treatment. However, formal proof of efficacy is needed. The purpose of this review is to summarize all historical clinical trials on COVID-19 infected patients treated with CP to provide precise evidence for the efficacy and effectiveness of CP therapy in severe COVID-19 patients. Although there are many clinical trials in progress, high-quality clinical evidence is still lacking to analyze the existing problems. Meanwhile, based on the previous successful outcomes, we recommend healthcare systems to use CP therapy cautiously in critically ill COVID-19 patients.
| S-EPMC7314270 | biostudies-literature
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| S-EPMC7190301 | biostudies-literature
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| S-EPMC7126959 | biostudies-literature
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| S-EPMC8251446 | biostudies-literature
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| S-EPMC8250757 | biostudies-literature
Project description:The outbreak of the coronavirus disease 2019 (COVID-19) has posed an unprecedented challenge to the health care communities across the globe. As of June 2, 2020, a total of 6,418,968 confirmed COVID-19 cases with 378,954 deaths have been reported. Different regions of the world have reported varying intensity of COVID-19 severity. The disease burden for COVID-19 depends on multiple factors like the local infection rate, susceptible population, mortality rate, and so on. The COVID-19 pandemic is a rapidly evolving emergency and is a subject of regular debate and advanced research. As of today, there is a lack of definitive treatment options for COVID-19 pneumonia. In search of alternative options, few drugs are being tested for their efficacy and repurposing. Preliminary reports have shown positive outcomes with Remdesivir and tocilizumab, but this needs further confirmation. Recently, the therapeutic application of Convalescent Plasma therapy in critically ill patients suffering from COVID-19 has gained momentum. We hereby discuss the convalescent plasma as a potential therapeutic option, its challenges of finding the ideal donors, transfusion medicine responsibilities, and the current global experience with its use.
| S-EPMC7927533 | biostudies-literature
Project description:Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 109/L vs. 0.76 × 109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.
| S-EPMC7196837 | biostudies-literature
Project description:Convalescent plasma (CP) therapy has been used since the early 1900s to treat emerging infectious diseases; its efficacy was later associated with the evidence that polyclonal neutralizing antibodies can reduce the duration of viremia. Recent large outbreaks of viral diseases for which effective antivirals or vaccines are still lacking has renewed the interest in CP as a life-saving treatment. The ongoing COVID-19 pandemic has led to the scaling up of CP therapy to unprecedented levels. Compared with historical usage, pathogen reduction technologies have now added an extra layer of safety to the use of CP, and new manufacturing approaches are being explored. This review summarizes historical settings of application, with a focus on betacoronaviruses, and surveys current approaches for donor selection and CP collection, pooling technologies, pathogen inactivation systems, and banking of CP. We additionally list the ongoing registered clinical trials for CP throughout the world and discuss the trial results published thus far.
| S-EPMC7430293 | biostudies-literature
Project description:Purpose To study the effect of interferon-α2 auto-antibodies (IFN-α2 Abs) on clinical and virological outcomes in critically ill COVID-19 patients and the risk of IFN-α2 Abs transfer during convalescent plasma treatment. Methods Sera from healthy controls, cases of COVID-19, and other respiratory illness were tested for IFN-α2 Abs by ELISA and a pseudo virus–based neutralization assay. The effects of disease severity, sex, and age on the risk of having neutralizing IFN-α2 Abs were determined. Longitudinal analyses were performed to determine association between IFN-α2 Abs and survival and viral load and whether serum IFN-α2 Abs appeared after convalescent plasma transfusion. Results IFN-α2 neutralizing sera were found only in COVID-19 patients, with proportions increasing with disease severity and age. In the acute stage of COVID-19, all sera from patients with ELISA-detected IFN-α2 Abs (13/164, 7.9%) neutralized levels of IFN-α2 exceeding physiological concentrations found in human plasma and this was associated with delayed viral clearance. Convalescent plasma donors that were anti-IFN-α2 ELISA positive (3/118, 2.5%) did not neutralize the same levels of IFN-α2. Neutralizing serum IFN-α2 Abs were associated with delayed viral clearance from the respiratory tract. Conclusions IFN-α2 Abs were detected by ELISA and neutralization assay in COVID-19 patients, but not in ICU patients with other respiratory illnesses. The presence of neutralizing IFN-α2 Abs in critically ill COVID-19 is associated with delayed viral clearance. IFN-α2 Abs in COVID-19 convalescent plasma donors were not neutralizing in the conditions tested. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-021-01168-3.
| S-EPMC8586830 | biostudies-literature