Abstract
Coronavirus disease 2019 (COVID-19) convalescent plasma (CovCP) infusions have been widely used for the treatment of hospitalized patients with COVID-19. The aims of this narrative review were to analyze the safety and efficacy of CovCP infusions in the overall population and in immunocompromised patients with COVID-19 and to identify the lessons learned concerning the use of convalescent plasma (CP) to fill treatment gaps for emerging viruses. Systematic searches (PubMed, Scopus, and COVID-19 Research) were conducted to identify peer-reviewed articles and pre-prints published between March 1, 2020 and May 1, 2021 on the use of CovCP for the treatment of patients with COVID-19. From 261 retrieved articles, 37 articles reporting robust controlled studies in the overall population of patients with COVID-19 and 9 articles in immunocompromised patients with COVID-19 were selected. While CovCP infusions are well tolerated in both populations, they do not seem to improve clinical outcomes in critically-ill patients with COVID-19 and no conclusion could be drawn concerning their potential benefits in immunocompromised patients with COVID-19. To be better prepared for future epidemics/pandemics and to evaluate potential benefits of CP treatment, only CP units with high neutralizing antibodies (NAbs) titers should be infused in patients with low NAb titers, patient eligibility criteria should be based on the disease pathophysiology, and measured clinical outcomes and methods should be comparable across studies. Even if CovCP infusions did not improve clinical outcomes in patients with COVID-19, NAb-containing CP infusions remain a safe, widely available and potentially beneficial treatment option for future epidemics/pandemics.
Highlights
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record
Convalescent plasma (CP) infusion is -p a method of passive immunization that was previously used during the Spanish influenza e pandemic in 1918 [11, 12] and later for the treatment of other severe viral infections [13,14,15]. l Despite the high level of investment and the numerous studies that evaluated the use of convalescent plasma (CovCP) to a treat COVID-19, inconsistencies in study design, efficacy endpoints, and reported data have limited n the ability to compare results among trials [16]. The objectives of this narrative review are to r analyze available data on the safety and efficacy of CovCP infusions for the treatment of COVID-19, u to evaluate whether CovCP could be useful for specific subpopulations of patients with COVID-19, Jo and to identify the lessons learned concerning the use of convalescent plasma (CP) to inform future treatment and investigations for emerging viruses
F Screening of the retrieved articles was performed by an independent reviewer to identify (i) robust o studies evaluating the efficacy and/or safety of CovCP in patients with COVID-19 versus control o patients with COVID-19 who did not receive CovCP, and (ii) all studies evaluating the r use of CovCP in immunocompromised patients with COVID-19 who were identified as a specific -p subpopulation potentially benefiting from CovCP treatment
Summary
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. COVID-19 convalescent plasma (CovCP) has been widely used CovCP is well tolerated but clinical effectiveness is inconsistent in COVID-19 patients No conclusion could be drawn on CovCP infusions use in immunocompromised patients CP is a safe and widely available option for emerging viruses without existing therapy The target population for CP should be identified based on disease pathophysiology. -proof Abstract re Coronavirus disease 2019 (COVID-19) convalescent plasma (CovCP) infusions have been widely used P for the treatment of hospitalized patients with COVID-19 The aims of this narrative review were to l analyze the safety and efficacy of CovCP infusions in the overall population and in a immunocompromised patients with COVID-19 and to identify the lessons learned concerning the use n of convalescent plasma (CP) to fill treatment gaps for emerging viruses. The objectives of this narrative review are to r analyze available data on the safety and efficacy of CovCP infusions for the treatment of COVID-19, u to evaluate whether CovCP could be useful for specific subpopulations of patients with COVID-19, Jo and to identify the lessons learned concerning the use of CP to inform future treatment and investigations for emerging viruses
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