Convalescent Plasma - A Review of this Potential Therapeutic Strategy for Combating Novel Coronavirus Disease 2019

Abstract

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.