Convalescent Plasma - A Review of this Potential Therapeutic Strategy for Combating Novel Coronavirus Disease 2019
DOI:
https://doi.org/10.21276/apjhs.2021.8.2.19Keywords:
Coronavirus disease 2019, Severe acute respiratory syndrome-coronaviruses, Convalescent plasma, World Health Organization, Passive immunization, TreatmentAbstract
Coronavirus disease 2019 (COVID-19) poses a significant threat to global health and World Health Organization (WHO) has declared this outbreak as a “public health emergency of international concern” on January 31, 2020. Globally, there is currently no effective post-infection prophylaxis for the treatment of COVID-19, although some drugs are being repurposed. Some vaccines have been developed and vaccination in different countries are undergoing at present, but duration of such vaccination in the long term protection is still unknown to us. Many therapeutic drugs, including chloroquine or hydroxychloroquine with or without azithromycin, remdesivir, favipiravir, nitazoxanide, ribavirin, baricitinib, penciclovir, ritonavir, and arbidol, have been tried as experimental medicine as they are thought to be reducing the viral load by different mechanisms but only a few has shown slight promising viral impact in the initial study. There are no antibodies for the prevention of COVID-19. Immune (i.e., “convalescent”) plasma (CP) refers to plasma that is collected from individuals, following resolution of infection and development of antibodies. Antibody therapy can be used to treat patients who are already manifesting symptoms of varying severity. CP has shown limited and moderate success, previously for Severe Acute Respiratory Syndrome-1 and Middle East Respiratory Syndrome, and for COVID-19 in China, and could serve as a short-term solution to suppress mortality rates in India and worldwide. Based on the limited scientific data, convalescent plasma transfusion (CPT) therapy in COVID-19 patient appears safe, clinically effective, and reduces mortality. Well-designed large multicenter clinical trial studies should be conducted urgently to establish the efficacy of CPT to COVID-19 patients. At present, in India ICMR-CP trial (Placid Trial) on COVID-19 patients had been done. CP was not associated with a reduction in progression to severe COVID-19 or all-cause mortality. With this review, we have tried to highlight progress of CP on COVID-19 patients.
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References
Felsenstein S, Herbert JA, McNamara, Hedrich CM. COVID-19: Immunology and treatment options. Clin Immunol 2020;215:108448.
Xiea M, Chen Q. Insight into 2019 novel coronavirus an updated intrim review and lessons from SARS-CoV and MERS-CoV. Int J Infect Dis 2020;94:119-24.
Coronavirus Disease 2019 (COVID-19) Situation Report 101. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019?gclid=EAIaIQobChMImbSrhJnH8AIVDhBgCh0wIAbcEAAYASAAEgJy4_D_BwE. [Last accessed on 2020 Oct 02].
Özdemir Ö, Arsoy HE. Convalescent (immune) plasma therapy with all aspects: Yesterday, today and COVID-19. Erciyes Med J 2020;42:252-9.
Keller MA, Stiehm ER. Passive immunity in prevention and treatment of infectious diseases. Clin Microbiol Rev 2000;13:602-14.
Bloch EM, Shoham S, Casadevall A, Sachais BS, Shaz B, Winters JL. Deployment of convalescent plasma for the prevention and treatment of COVID-19. J Clin Invest 2020;130:2757-65.
Casadevall A, Pirofski LA. The convalescent sera option for containing COVID-19. J Clin Investig 2020;130:1545-8.
Burnouf T, Seghatchian J. Ebola virus convalescent blood products: Where we are now and where we may need to go. Transfus Apher Sci 2014;51:120-5.
Luke TC, Casadevall A, Watowich SJ, Hoffman SL, Beigel JH, Burgess TH. Hark back: Passive immunotherapy for influenza and other serious infections. Crit Care Med 2010;38 Suppl 4:e66-73.
Marano G, Vaglio S, Pupella S, Facco G, Catalano L, Liumbruno GM, et al. Convalescent plasma: New evidence for an old therapeutic tool? Blood Trans 2016;14:1-6.
Van Griensven J, Edwards T, de Lamballerie X, Semple MG, Gallian P, Baize S. Evaluation of convalescent plasma for ebola virus disease in guinea. N Engl J Med 2016;374:33-42.
Hung IF, To KK, Lee CK, Lee KL, Chan K, Yan WW, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis 2011;52:447-56.
Soo YO, Cheng Y, Wong R, Hui DS, Lee CK, Tsang KK, et al. Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients. Clin Microbiol Infect 2004;10:676‐8.
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A 2020;117:9490‐6.
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically Ill patients with COVID-19 with convalescent plasma. JAMA 2020;323:1582‐9.
Mair-Jenkins J, Saavedra-Campos M, Baillie K, Cleary P, Khaw FM, Lim WS, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral aetiology: A systematic review and exploratory meta-analysis. J Infect Dis 2014;211:80-90.
Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis 2005;24:44‐6.
Arabi YM, Hajeer AH, Luke T, Raviprakash K, Balkhy H, Johani S, et al. Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, Saudi Arabia. Emerg Infect Dis 2016;22:1554‐61.
Beigel JH, Aga E, Elie-Turenne MC, Cho J, Tebas P, Clark CL, et al. Anti-influenza immune plasma for the treatment of patients with severe influenza A: A randomised, double-blind, phase 3 trial. Lancet Respir Med 2019;7:941-50.
Alhazzani W, Moller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med 2020;46:854-87.
Li G, Chen X, Xu A. Profile of specific antibodies to the SARS-associated coronavirus. N Engl J Med 2003;349:508-9.
Zhao Q, He Y. Challenges of convalescent plasma therapy on COVID-19. J Clin Virol 2020;127:104358.
Placid Trial. Available from: https://www.icmr.gov.in/pdf/covid/techdoc/Revised_List_of_Inst_PLACID_10052020.pdf. [Last accessed on 2021 Jan 12].
Zeng QL, Yu ZJ, Gou JJ, Li GM, Ma SH, Zhang GF, et al. Effect of convalescent plasma therapy on viral shedding and survival in COVID-19 patients. J Infect Dis 2020;222:38-43.
Ahn JY, Sohn Y, Lee SH, Cho Y, Hyun JH, Baek YJ, et al. Use of convalescent plasma therapy in two COVID-19 patients with acute respiratory distress syndrome in Korea. J Korean Med Sci 2020;35:e149.
Rajendran K, Narayanasamy K, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID-19: Systematic review. J Med Virol 2020;92:1475-83.
Langhi DM, Santis GC, Bordin JO. COVID-19 convalescent plasma transfusion. Hematol Transfus Cell Ther 2020;42:113-5.
Available from: https://www.mygov.in/covid-19. [Last accessed on 2021 Mar 12].
Bakhtawar N, Usman M, Khan MMU. Convalescent plasma therapy and its effects on COVID-19 patient outcomes: A systematic review of current literature. Cureus 2020;12:e9535.
Abolghasemi H, Eshghi P, Cheraghali AM, Fooladi AA, Moghaddam FB, Imanizadeh S, et al. Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study. Transfus Apher Sci 2020;2020:102875.31. Estcourt LJ, Roberts DJ. Convalescent plasma for covid-19. BMJ 2020;370:m3516.
Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: A randomized clinical trial. JAMA 2020;324:460-70.
Plasma Therapy May be Scrapped from COVID-19 National Treatment Protocol Soon: ICMR Chief. Available from: https://www.firstpost.com/india/plasma-therapy-could-be-scrapped-from-covid-19-national-treatment-protocol-soon-icmr-chief-8934211.html. [Last accessed on 2021 Jan 12].
Agarwal A, Mukherjee A, Kumar G, Chatterjee P, Bhatnagar T, Malhotra P, et al. Convalescent plasma in the management of moderate covid-19 in adults in India: Open label phase II multicentre randomised controlled trial (PLACID Trial). BMJ 2020;371:m3939.
The Promise of COVID-19 Convalescent Plasma Therapy. Available from: https://www. asm.org/articles/2020/july/the-promise-of-covid-19-convalescent-plasma-therapy. [Last accessed on 2021 Jan 12].
Khaire NS, Jindal N, Yaddanapudi LN, Sachdev S, Hans R, Sachdeva N, et al. Use of convalescent plasma for COVID-19 in India: A review and practical guidelines. Indian J Med Res 2021;153:64-85.
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Copyright (c) 2021 Agnik Pal, Arpan Ray, Amit Kiran Pramanik, Aditi Das, Sukanta Sen
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