Effectiveness and Feasibility of Convalescent Blood Transfusion to Reduce COVID-19 Fatality Ratio

Abstract

As of April 7th 2020, COVID-19 has spread to 209 countries with more than 1,400,000 cases and more than 80,000 deaths. The rapidly increasing number of patients mandates the consideration of potential treatments for patients under severe and critical conditions. Convalescent plasma (CP) treatment refers to the approach of infusing patients with plasma from recently recovered patients. CP appears to be a possible therapeutic option to manage patients suffering from severe or even lethal infectious disorders, in which traditional therapies have failed to obtain any result. In the present study, we develop a mathematical model that couples the disease transmission compartmental system with treatment-donation-stockpile dynamics for an optimal implementation of CP therapy to examine potential benefits and complications in the logistic realization of this therapy in a large-scale population. We parameterize the model with COVID-19 epidemics in Italy, and conduct scenario analyses to compare outcomes of population-wide CP therapy and to examine the maximum number of CP donation processions per day under various levels of the effectiveness of the intervention measures implemented in the country. Under the assumption that the fatality ratio of CP is 10% and the population-wide CP was initiated on March 31st 2020, we show that an early start of the population-wide CP therapy can save as many as 6; 451 lives (ranging from 3; 074 to 26; 500 depending on containment effectiveness), while the demand of apheresis use is manageable in all scenarios: the maximum demand is 485 per day (ranging from 455 to 934 depending on containment effectiveness). Given that Italy has 61 centers with apheresis this maximum demand level corresponds to a daily average of 8 processions of CP donation (ranging from 7:5 to 15 depending on containment effectiveness) being performed by each center.