Convalescent Plasma Collection Research Articles

Trends of participants in convalescent plasma donation for COVID-19 in Japan as the pandemic evolved

BackgroundWe aimed to investigate chronological changes in the characteristics of participants in a coronavirus disease 2019 convalescent plasma donation study that may benefit optimal collection methods in the future. MethodsData from a convalescent plasma donation study from April 30, 2020 to November 5, 2021 were collected and analyzed. After August 23, 2021, an interim analysis of factors linked to higher antibody titers led us to restrict our participant recruitment criteria to participants who were within 4 months of disease onset and to patients who were otherwise most likely to have sufficiently high antibody titers. Overall, 1299 samples from 1179 patients were analyzed. ResultsOver the duration of the study, 35.9% of the samples were deemed eligible for convalescent plasma collection. The overall eligibility rate initially declined, dipping to <20% after one year. During this period, the proportion of enrolled samples from patients who had severe illness also declined, and the proportion of samples from participants who were >120 days post disease onset increased. After the addition of days from onset and vaccination status to our participant recruitment criteria, the eligibility rate improved significantly. ConclusionsAs outbreaks of emerging infectious disease occur, it is desirable to construct and implement a scheme for convalescent plasma donation promptly and to monitor the eligibility rate over time. If it declines, promptly analyze and resolve the associated factors. Additionally, vaccine development and infection prevalence are likely to influence the effective recruitment of participants with high antibody titers.

COVID-19 Convalescent Plasma Collection: A Cross-Sectional Study From the Perspective of Transfusion Medicine

Introduction: Convalescent plasma from cured symptomatic COVID-19 patients was one of the many treatment options rolled out during the COVID-19 pandemic. The high levels of viral neutralizing antibodies in plasma of those who had contracted the disease, and clinical improvement in viral pneumonias like Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) treated with convalescent plasma was the consideration behind this. Aim: To study recruitment including demographic characteristics of plasma donors, and recording any adverse donor reactions. Materials and Methods: This prospective cross-sectional study was conducted at the Department of Transfusion Medicine, Govt. Medical College, Kozhikode, Kerala, India from July 2020 to March 2021. All plasma donors who met the inclusion criteria as per the Kerala Government order permitting compassionate use of convalescent plasma were included in the study. Plasma collection was done using the Hemonetics MCS+ (MultiComponent System) Apheresis system and semiquantitative in-vitro determination of human antibodies, immunoglobulin class IgG against S1 domain of spike protein of SARS-CoV-2 was performed using EUROIMMUN anti-SARS CoV -2 ELISA. Results: Among the124 convalescent plasma donors, more than 90% donors were males of the age group 18-40 years and with a prior history of blood donation (repeat donors). Ninety donors (73%) had symptomatic COVID-19, 34 (27%) were asymptomatic. COVID-19 antibody determination showed 82 (66%) positive cases, 32 (26%) negative cases and 10 (8%) cases with borderline values. COVID-19 antibody was positive in 65 (72.2%) of the donors who were symptomatic compared to 17 (50%) asymptomatic donors. Adverse reactions were noted in 40 cases (32.26%), of which the procedure was discontinued in two. Conclusion: Donors with prior donation history and in the age group 18-40 years are more likely to donate. This study also showed a significant antibody response in symptomatic COVID-19 donors versus the asymptomatic. Low rate of serious adverse reactions amounting to stopping the procedure confirms its safety.

COVID-19 convalescent plasma: current status, lessons from the past and future perspectives

When the COVID-19 pandemic hit, blood transfusion services worldwide started collection of convalescent plasma as early as possible, as exemplified by the response in Norway. There were challenges related to donor selection, donor safety, testing for relevant antibodies and indications for and dosing of the convalescent plasma. As more knowledge became available, the product quality was more standardised. Multiple case reports, observational studies and some randomized studies were published during the pandemic, as well as laboratory studies reporting different approaches to antibody testing. The results were conflicting and the importance of convalescent plasma was disputed.Even though there has been strong international collaboration with involvement of many key organisations, we may better prepare for the next pandemic. An even stronger, more formalised collaboration between these organisations could provide more clear evidence of the importance of convalescent plasma, based on the principles of passive immunisation.

Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy

IntroductionConvalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. ObjectivesOur objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. MethodsA multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. ResultsFrom the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p = 0.002), hospital admission (p = 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. ConclusionThe implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.

Regulatory challenges of convalescent plasma collection during the evolving stages of COVID-19 pandemic in the United States.

Regulations concerning COVID-19 convalescent plasma (CCP) collection during different stages of the pandemic have been challenging for the blood establishments. With the availability of advancing evidence about the safety and efficacy of CCP and the development of COVID-19 vaccines, the FDA regulations have been promptly updated at different stages of the pandemic. Evidence regarding the efficacy of high titer CCP and the antibody titer threshold required to qualify a unit as 'high titer', is still evolving. Evidence about the efficacy during early in the course of disease and in immunocompromised patients also requires larger prospective randomized controlled trials, and the major drawback of many existing clinical trials is their lack of randomization. We review the FDA regulatory updates for CCP collection during the pandemic and the challenges faced by blood donation centers, summarize the evidence for CCP efficacy, including efficacy against the SARS-CoV-2 variants and describe the future challenges and directions. This article is protected by copyright. All rights reserved.

Effectiveness and Controversy of Convalescent Plasma Therapy for Coronavirus Disease 2019 Patients.

Since the coronavirus disease 2019 (COVID-19) began to spread, it remains pandemic worldwide. The European Medicines Agency's human medicines committee and Food and Drug Administration have only granted a conditional marketing authorization for remdesivir to treat COVID-19. It is essential to apply other valuable treatments. Convalescent plasma (CP), donated by persons who have recovered from COVID-19, is the cellular component of blood that contains specific antibodies. Therefore, to determine the feasibility of CP for COVID-19, the effectiveness and controversy are discussed in depth here. It is suggested that CP plays a certain role in the treatment of COVID-19. As a treatment, it may have its own indications and contraindications, which need to be further discussed. Meanwhile, it is critical to establish a standard procedure for treatment from CP collection, preservation, transport, to transfusion, and conduct some large sample randomized controlled trials to confirm the transfusion dosage, appropriate time, frequency, and actively prevent adverse outcomes that may occur.

Lessons learned in the collection of convalescent plasma during the COVID-19 pandemic.

BackgroundThe lack of definitive treatment or preventative options for COVID‐19 led many clinicians early on to consider convalescent plasma (CCP) as potentially therapeutic. Regulators, blood centres and hospitals worldwide worked quickly to get CCP to the bedside. Although response was admirable, several areas have been identified to help improve future pandemic management.Materials and methodsA multidisciplinary, multinational subgroup from the ISBT Working Group on COVID‐19 was tasked with drafting a manuscript that describes the lessons learned pertaining to procurement and administration of CCP, derived from a comprehensive questionnaire within the subgroup.ResultsWhile each country’s responses and preparedness for the pandemic varied, there were shared challenges, spanning supply chain disruptions, staffing, impact of social distancing on the collection of regular blood and CCP products, and the availability of screening and confirmatory SARS‐CoV‐2 testing for donors and patients. The lack of a general framework to organize data gathering across clinical trials and the desire to provide a potentially life‐saving therapeutic through compassionate use hampered the collection of much‐needed safety and outcome data worldwide. Communication across all stakeholders was identified as being central to reducing confusion.ConclusionThe need for flexibility and adaptability remains paramount when dealing with a pandemic. As the world approaches the first anniversary of the COVID‐19 pandemic with rising rates worldwide and over 115 million cases and 2·55 million deaths, respectively, it is important to reflect on how to better prepare for future pandemics as we continue to combat the current one.

Constraints and challenges in convalescent plasma collection amidst the Covid 19 pandemic- strategies and recommendations to overcome these.

BackgroundCOVID 19 is an acute respiratory disease caused by infection by the virus SARS-COV-2 and has been declared as a pandemic whose specific treatment is still not established. One of the options in the treatment is Convalescent plasma (CP) therapy when there is presence of required amount of neutralizing antibodies in the plasma of recovered COVID patients. Our objective was to analyze the challenges and the constraints encountered in motivation of COVID 19 recovered persons to come for the screening procedures and to convince the selected persons to come for Plasma donation voluntarily.Material & methodsThe present retrospective observational study was conducted for a period of five and half months. Out of 1515 number of persons contacted telephonically for Plasma donation, 1291 persons came for screening of whom 1028 persons were eligible for donation, 263 cases were deferred and 966 persons finally donated.ResultsMaximum number of acceptance cases were from males-(98.7%). Of the accepted cases, (41.73%) were from the 18-30 years’ age group. 33.94% were from blood group ‘O’ Rh D positive giving maximum contribution from any blood group. 38.3% of the accepted cases had resolution of all COVID symptoms within time period of 28-40 days. Maximum number of accepted individuals (39.75%) had suffered from multiple symptoms followed by 39.02% of asymptomatic persons. Highest number of Plasma donation was contributed by Odisha Government Police personnel (51.56%).DiscussionIn this global ongoing pandemic, the “Fear Factor of contracting the disease” has acted as a major challenge in motivating and convincing a COVID recovered patient for plasma donation. The challenge before the medical professionals was to motivate, educate and convince the potential donors and the society about the likely benefits of convalescent plasma. This could be finally overcome with the help of positive orientation through social and conventional media as well as mass appeal from government side on the benefits of plasma therapy in saving lives in the present pandemic.

Factors driving availability of COVID-19 convalescent plasma: Insights from a demand, production, and supply model.

BackgroundCOVID‐19 Convalescent Plasma (CCP) is a promising treatment for COVID‐19. Blood collectors have rapidly scaled up collection and distribution programs.MethodsWe developed a detailed simulation model of CCP donor recruitment, collection, production, and distribution processes. We ran our model using varying epidemic trajectories from 11 U.S. states and with key input parameters drawn from wide ranges of plausible values to identify key drivers of ability to scale collections capacity and meet demand for CCP.ResultsUtilization of available CCP collections capacity followed increases in COVID‐19 hospital discharges with a lag. Utilization never exceeded 75% of available capacity in most simulations. Demand was met for most of the simulation period in most simulations, but a substantial portion of demand went unmet during early, sharp increases in hospitalizations. For epidemic trajectories that included multiple epidemic peaks, second wave demand could generally be met due to stockpiles established during the decline from an earlier peak. Apheresis machine capacity (number of machines) and probability that COVID‐19 recovered individuals are willing to donate were the most important supply‐side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks.ConclusionsEpidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success.

Rapidly Establishing a Hospital-Based Convalescent Plasma Collection Center With the Alyx Apheresis Collection Device

The effort to collect convalescent plasma from individuals who recovered from COVID-19 began in earnest during the spring of 2020. Either whole blood or apheresis donations were obtained, the latter yielding higher numbers of units per donor per collection and more frequent collections. The NorthShore University HealthSystem blood donor center purchased 2 Alyx (Fresenius Kabi) apheresis plasma collection devices and quickly implemented them in order to collect COVID-19 convalescent plasma. Apheresis-experienced and inexperienced phlebotomists operated the instruments. Donors were collected >14 days from symptom resolution and all donors were negative by SARS-CoV-2 nasopharyngeal swab. Both internal metrics of performance as well as a post donation survey were used to evaluate the feasibility implementing this collection program. During the first 100 days of the collection program, 650 plasma units were collected. In particular, during the first week of the program, 38 units were collected and distributed to hospitals under the emergency investigational new drug and expanded access program. Fifty-one donors (15%) were deferred due to vital signs out of range or donor screening questions. Thirty-one donors (10%) were deferred due to positive nasopharyngeal swab. Lower than target yield occurred in 16.6% of collections due to donor reactions or flow errors. Donors rated the overall program lower, but not the staff, when they reported symptoms related to collection. In conclusion, a hospital-based apheresis convalescent plasma collection program can be rapidly implemented. Donor reaction rates and vein infiltration rates should be carefully monitored for each phlebotomist.

COVID-19 Repeated Convalescent Plasma Collection: Analysis of 149 Donations from 88 French Military Health Workers

Background: Passive therapy with convalescent plasma (CP) could be an effective and safe treatment option in COVID-19 patients. Neutralizing antibodies present in CP generated in response to SARS-CoV-2 infection and directed against the receptor-binding domain of the spike protein are considered to play a major role in the viral clearance. CP infusion may also contribute to the modulation of the immune response through its immunomodulatory effect. We describe for the first time the effectiveness of a CP collection protocol from repeated donations in young patients. Materials and Methods: We enrolled health service workers who experienced mild to moderate COVID-19 and from whom several donations have been collected. No minimal severity threshold and no biological cure criteria were required. Donors could return to a second plasma donation 14 days after the first donation. A minimal neutralizing antibody titer of 1:40 was considered for clinical use. Results: Eighty-eight donors were included (median age 35 [28–48] years, 41 women), and 149 plasma products were collected. COVID-19 were mainly WHO stage 2 infections (96%). Among the 88 first donations, 76% had neutralizing antibody titers higher than or equal to 1:40. Eighty-eight percent of donors who came for a second donation had a neutralizing antibody titer of 1:40. Median durations were 15 (15–19) and 38 (33–46) days from the first to the second donation and from recovery to the second donation, respectively. Sixty-nine percent of donors who came for a third donation had a neutralizing antibody titer of 1:40. Median durations were 16 (13–37) and 54 (49–61) days from the second to the third donation and from recovery to the third donation, respectively. No significant difference was observed between the IgG ratio and the age of the donors or the time between recovery and donation. The average IgG ratio did not significantly vary between donations. When focused on repeated blood donors, no significant differences were observed either. Conclusion: The recruitment of young patients with a mild to moderate CO­VID-19 course is an efficient possibility to collect CP with a satisfactory level of neutralizing antibodies. Repeated donations are a well-tolerated and effective way of CP collection.

Research initiatives of blood services worldwide in response to the covid-19 pandemic.

While coronavirus (COVID-19) is not transfusion-transmitted, the impact of the global pandemic on blood services worldwide is complex. Convalescent plasma may offer treatment, but efficacy and safety are not established. Measuring seroprevalence in donors would inform public health policy. Here, we survey blood services around the world to assess the different research programmes related to COVID-19 planned or in progress. Blood collection services were surveyed in June 2020 to determine whether they were participating in serosurveys or convalescent plasma collection and clinical trials. A total of 48 countries (77% of those contacted) responded. Seroprevalence studies are planned or in progress in 73% of countries surveyed and in all continents, including low- and middle-income countries. Most aimed to inform public health policy. Convalescent plasma programmes have been initiated around the globe (79% of surveyed), about three quarters as clinical trials in high-, middle- and low-income countries. Blood services around the world have drawn upon their operational capacity to provide much-needed seroprevalence data to inform public health. They have rapidly implemented preparation of potential treatment when few treatments are available and mostly as clinical trials. At the same time, they must continue to provide blood products for recipients despite challenges of working in a state of emergency. It is important to track and coordinate research efforts across jurisdictions to gain a composite evidence-based view that will influence future practice and preparative strategies.

Convalescent plasma as a treatment modality for coronavirus disease 2019 in Sudan

Coronavirus disease 2019 (COVID-19) is a disease spreading rapidly in Sudan, the rest of the African continent and the world with no known definitive treatment or vaccines. However, among many treatment interventions being tested globally, beneficial effects and clinical improvements have been reported when convalescent plasma is used for treating COVID-19 patients. We prepared a guiding protocol for treating early to moderate COVID-19 patients with plasma transfusion from convalescent COVID-19 patients. This protocol was deduced based on previously published reports and studies that evaluated and tested convalescent plasma as a prospective therapy for COVID-19 patients. The protocol covers instructions on patient and donor selection criteria, plasma harvesting, plasma product specifications, dosage and precautions for convalescent plasma collection and transfusion process. Altogether, we prepared a treatment protocol that is tailored to the context of Sudan to be adopted by Sudan's health authority. Moreover, it will also provide reference for researchers to design open label clinical trials for convalescent plasma transfusion.

Feasibility of a pilot program for COVID-19 convalescent plasma collection in Wuhan, China.

BACKGROUNDA novel coronavirus has caused an international outbreak. Currently, there are no specific therapeutic agents for coronavirus infections. Convalescent plasma (CP) therapy is a potentially effective treatment option.METHODSPatients who had recovered from COVID‐19 and had been discharged from the hospital for more than 2 weeks were recruited. COVID‐19 convalescent plasma (CCP)‐specific donor screening and selection were performed based on the following criteria: 1) aged 18‐55 years; 2) eligible for blood donation; 3) diagnosed with COVID‐19; 4) had two consecutive negative COVID‐19 nasopharyngeal swab tests based on PCR (at least 24 hr apart) prior to hospital discharge; 5) had been discharged from the hospital for more than 2 weeks; and 6) had no COVID‐19 symptoms prior to convalescent plasma donation. In addition, preference was given to CCP donors who had a fever lasting more than 3 days or a body temperature exceeding 38.5°C (101.3°F), and who donated 4 weeks after the onset of symptoms. CCP collection was performed using routine plasma collection procedures via plasmapheresis. In addition to routine donor testing, the CCP donorsʼ plasma was also tested for SARS‐CoV‐2 nucleic acid and S‐RBD‐specific IgG antibody.RESULTSOf the 81 potential CCP donors, 64 (79%) plasma products were collected. There were 18 female donors and 46 male donors. There were 34 first‐time blood donors and 30 repeat donors. The average time between CCP collection and initial symptom onset was 49.1 days, and the average time between CCP collection and hospital discharge was 38.7 days. The average volume of CCP collected was 327.7 mL.All Alanine transaminase (ALT) testing results met blood donation requirements. HIV Ag/Ab, anti‐HCV, anti‐syphilis, and HBsAg were all negative; NAT for HIV, HBV, and HCV were also negative. In addition, all of the CCP donorsʼ plasma units were negative for SARS‐CoV‐2 RNA. Of the total 64 CCP donors tested, only one had an S‐RBD‐specific IgG titer of 1:160, all others had a titer of ≥1:320.CONCLUSIONBased on a feasibility study of a pilot CCP program in Wuhan, China, we demonstrated the success and feasibility of CCP collection. In addition, all of the CCP units collected had a titer of ≥1:160 for S‐RBD‐specific IgG antibody, which met the CCP quality control requirements based on the Chinese national guidelines for CCP.

Industry call for COVID‐19 convalescent plasma collections

The treatment of COVID-19 patients, especially in severe conditions, presents a challenge to medical professionals. Plasma from recovered COVID-19 patients is a potential and promising therapeutic option, and efforts are underway at different levels to encourage convalescent plasma donations [1, 2]. Convalescent plasma obtained by apheresis from the blood of healthy people who overcame the disease contains specific antibodies against coronavirus SARS-CoV-2. It can be used for immediate transfusion and/or for the manufacture of purified antibodies in the form of polyclonal hyperimmune immunoglobulins. The latter process is lengthy (at least 6 months) and requires large volumes of plasma (at least one thousand litres) for production. Global manufacturers are already working on SARS-CoV-2-specific hyperimmune immunoglobulin therapy options [2]. The success of these efforts requires a sufficient number of donations from willing and eligible patients recovered from COVID-19. It is essential to establish the efficacy of both therapies, as curative and prophylactic treatments in well-thought clinical trials, some of which are already underway [1, 3]. Although the literature on convalescent plasma treatment of COVID-19 is scarce, a few recent publications described positive outcomes in a small number of patients (27 total cases), mainly in critical conditions, who received convalescent plasma from COVID-19 recovered persons [4-8]. Despite limitations, these studies provide supporting evidence for evaluating COVID-19 convalescent plasma in more rigorous investigations. Convalescent plasma is a long-standing therapy that has been used in other infectious and respiratory diseases, including SARS [9]. A large study based on a systematic review and exploratory meta-analysis found that the treatment of SARS patients with convalescent plasma or serum appears to be safe and may reduce mortality rates, especially when administered soon after the disease onset [10]. The U.S. Food and Drug Administration has established a pathway to allow the use of COVID-19 convalescent plasma during the public health emergency [https://www.fda.gov/vaccines-blood-biologics/investigational-new-drug-ind-or-device-exemption-ide-process-cber/recommendations-investigational-covid-19-convalescent-plasma]. The European Commission runs a programme for COVID-19 convalescent plasma collection and transfusion [https://ec.europa.eu/health/blood_tissues_organs/covid-19_en]. However, both activities are limited and do not consider other uses. We posit that COVID-19 convalescent plasma should be collected for immediate transfusions and the manufacturing of hyperimmune immunoglobulin therapies. In addition to COVID-19 survivors who can donate plasma 14 days after complete resolution of symptoms, plasma donation should be encouraged in individuals who tested positive for the SARS-CoV-2 but did not develop COVID-19 after a 14-day incubation period [https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/updated-information-blood-establishments-regarding-novel-coronavirus-covid-19-outbreak]. These asymptomatic individuals, even in the absence of significant knowledge about the levels of SARS-CoV-2 neutralizing antibodies in their blood, may represent a substantial proportion of the infected population and could contribute significantly to the COVID-19 convalescent plasma supply. Once vaccines are developed against SARS-CoV-2 infection, the plasma of vaccinated individuals can be used to produce hyperimmune immunoglobulin therapies of high specificities and titres. Both COVID-19 convalescent plasma and especially hyperimmune immunoglobulin should be considered for pre- and post-exposure treatment for individuals at higher risk for severe illness due to age, poor health and/or other medical conditions, for example abnormalities associated with the immune system function, serious lung pathologies or coagulation disorders. Prophylactic interventions for selected frontline workers with high exposure to infection may allow them to perform critical activities without becoming sick. Medical professionals play an important role in building awareness about the significance of blood and plasma donation as an essential component of the broad healthcare infrastructure. It is highly important to continue informing wide networks about the critical and ongoing need for donations throughout the COVID-19 pandemic and beyond. The need for blood and plasma is greater than ever. On behalf of the standard-setting and global advocacy organization that represents plasma donation centres and manufacturers of plasma protein therapies including human normal and hyperimmune immunoglobulins, we support these efforts with great enthusiasm and appreciation. All authors contributed equally to the writing of this manuscript and approved the final version. Authors report no conflict of interest for this article. Amy Chevalier Efantis, a full-time PPTA employee, declares no funding sources associated with the writing of this manuscript. Brenna Raines, a full-time PPTA employee, declares no funding sources associated with the writing of this manuscript. Larisa Cervenakova, a full-time PPTA employee, declares no funding sources associated with the writing of this manuscript.

Covid‐19 pandemic‐ response to challenges by blood transfusion services in India: a review report

AbstractThe role of blood transfusion services in a pandemic depends on the type, potential of community spread and risk of transfusion transmissibility. The COVID‐19 pandemic is the biggest pandemic of the 21st century, affecting over 3 million people across the globe as of late April 2020. In India, the count of infected persons and deaths are rising gradually, and to prevent the community spread of the SARS‐CoV‐2 virus, the Government of India announced national lockdown which affected the blood transfusion services also. There are more than 3000 decentralized blood centres all over the country. The major challenges to blood transfusion services are recruitment of healthy blood donors, follow‐up of donors and patients, inventory management, staff safety and adequacy for emergency work and consumable management. Blood transfusion services also participate in treatment of COVID‐19 patients by convalescent plasma collection from recovered patients. Blood transfusion services should have a strategic plan to respond to challenges generated during a pandemic which focuses on shortage, wastage and supply of blood and components in a cost‐effective manner. In this review article, we will discuss the challenges to blood transfusion services of India due to COVID‐19 pandemic and response to these challenges with experience to previous outbreaks.

The use of passive immunity (Plasma) treatment for SARS-CoV-2 virus in Basra, Iraq

Reports from China and South Korea have shown improvements in critically ill Covid-19 patients using convalescent plasma from recovered individuals. On 25 March 2020, the Food and Drug Administration announced convalescent plasma guidelines for Covid-19 patients. We collected plasma from one donor by a novel donation method that could safely provide plasma sufficient to 10 patients. Four critically ill patients received convalescent plasma and had well-recognized clinical improvements in 12 to 72 hours. To our knowledge, we are the first to report this novel convalescent plasma collection method. In the view of lack of enough donors, this method can be a breakthrough in the treatment of such a rapidly spreading illness.

Pivotal role of convalescent plasma in managing emerging infectious diseases.

Pivotal role of convalescent plasma in managing emerging infectious diseases.

Challenges in the collection of convalescent plasma for COVID-19 patients at a plasma therapy trial site

Background and Objectives: With no proven treatment guidelines for COVID-19, human convalescent plasma is an option and has been under trial worldwide. In India, Indian Council for Medical Research (ICMR), started a Mulicentric Trial for the use of convalescent plasma in the treatment of COVID patients. The purpose of this paper is to analyse the challenges encountered in the collection of convalescent plasma from COVID recovered patients at a trial site. Methods: The current prospective study was carried out in a tertiary care hospital based blood centre catering to COVID patients and a trial site for Plasma therapy by ICMR. For analysing the challenges in the collection of convalescent plasma, the discharged patients were contacted telephonically. After applying eligibility criteria, the reasons of deferral were assessed. Data was collected and analysed. Results: The current prospective study was carried out during the period of 1st April 2020 to 15th May 2020. During this period, a total of 496 patients got discharged. After applying deferral criteria, 113 were eligible, out of which only 13 (11.5%) consented to come to donate plasma. Conclusion: In a global ongoing pandemic, the “Fear Factor” is a constraint and a major challenge to motivate and convince a COVID recovered patient for plasma donation. The challenge for the medical professionals is to motivate, convince and educate the potential donors and society about the likely benefits of COVID Convalescent Plasma.

Practical limitations of convalescent plasma collection: a case scenario in pandemic preparation for influenza A (H1N1) infection

To ensure a good preparedness for pandemic influenza A (H1N1), a study was conducted to investigate clinical effectiveness of hyperimmune intravenous globulin (H-IVIG) prepared from convalescent plasma donated by recovered patients. This article reports on the outcome of the collection phase of the study. Starting on August 26, 2009, all confirmed patients aged between 18 and 55 years were invited for participation into the study and screen for plasma donation eligibility. Effective September 17, 2009, those who were unwilling to consider screening for plasma were asked to donate whole blood. Plasma collected or separated from whole blood had to demonstrate sufficient neutralization antibodies titers of 40 or more before being channeled for H-IVIG production. By October 31, 2009, a total of 9101 persons were successfully contacted. A total of 1309 screening and 619 whole blood donation appointments were made. In the former 786 (60.0%) attended screening but only 301 could donate plasma by apheresis because of failure to meet blood donation eligibility criteria, failed laboratory tests, insufficient neutralization antibody titers, and inability to make the apheresis appointment. For those who opted for whole blood donation, 379 (61.2%) had attended and donated. A total of 276 L of convalescent plasma with sufficient neutralization antibodies titers was collected for H-IVIG production. The study highlighted a number of practical limitations in convalescent plasma collection programs and plasmapheresis is always the preferred mode of collection. It provided valuable learning experience for the blood transfusion service in future planning when large-scale collection is required.