Role Of Convalescent Plasma Therapy Research Articles

P1618: CLINICAL OUTCOME OF COVID-19 CONVALESCENT PLASMA TRANSFUSION IN CHRONIC KIDNEY DISEASE PATIENTS ON RENAL REPLACEMENT THERAPY WITH SEVERE TO CRITICAL COVID-19 DISEASE

Background: Convalescent plasma therapy (CPT) has been explored for Coronavirus disease 2019 (COVID-19), but limited data exists for Chronic Kidney Disease (CKD) patients. Since the effects of COVID-19 therapies are still under study, CPT remains an option for these patients in the absence of other effective therapy. Aims: This study aimed to compare the clinical outcome of severe to critical COVID-19 patients with CKD on RRT who received COVID-19 CPT versus those who did not. Methods: Retrospective study. Primary outcome was clinical improvement defined as mortality or whether discharged alive or improvement in WHO 6-point severity scale within 28 days. Secondary outcomes include factors associated with clinical improvement such as CPT’s effect on pulmonary status, timing of CPT, effects on hematologic profile and inflammatory markers. Results: Total of 44 CKD patients were included. Half were given CPT, half were not. Mean age was 59±12.7 and 51±15.6 respectively; 68.2% male, 31.8% female. No significant difference was found in the clinical outcome of severe to critical COVID-19 CKD patients who received CPT and those who did not. However, significant reduction in HsCRP, procalcitonin and ferritin pre and post CPT was found. This provide support in the role of CPT in reducing the inflammatory cytokine course of COVID-19 in CKD patients. Image:Summary/Conclusion: Convalescent plasma transfusion did not show significant difference in the clinical outcome of severe to critical COVID-19 CKD patients, but was associated with decreasing trends of HsCRP, procalcitonin and ferritin, which are poor prognosticators of COVID-19 disease.

A Multi-Center, Open-Label, Randomized Controlled Trial to Evaluate the Efficacy of Convalescent Plasma Therapy for Coronavirus Disease 2019: A Trial Protocol (COVIPLA-RCT).

Background: Coronavirus disease 2019 is a global public health concern. As of December 2020, the therapeutic agents approved for coronavirus disease 2019 in Japan were limited to two drugs: remdesivir, an antiviral drug, granted a Special Approval for Emergency on 7 May 2020, and dexamethasone, which has an anti-inflammatory effect. The aim of this study is to evaluate the efficacy of convalescent plasma collected from donors who recovered from coronavirus disease 2019. Methods: This is an open-label, randomized controlled trial comprising two groups: a convalescent plasma and a standard-of-care group. Plasma administered to patients with coronavirus disease 2019 randomized in the convalescent plasma group of this trial will be plasma that has been collected and stored in an associated study. Patients with a diagnosis of mild coronavirus disease 2019 will be included in this trial. The efficacy of convalescent plasma transfusion will be evaluated by comparing the convalescent plasma group to the standard-of-care group (without convalescent plasma transfusion) with respect to changes in the viral load and other measures. The primary endpoint will be time-weighted average changes in the SARS-CoV-2 virus load in nasopharyngeal swabs from day 0 to days 3 and 5. It is hypothesized that the intervention should result in a decrease in the viral load in the convalescent plasma group until day 5. This endpoint has been used as a change in viral load has and been used as an index of therapeutic effect in several previous studies. Discussion: The proposed trial has the potential to prevent patients with mild COVID-19 from developing a more severe illness. Several RCTs of convalescent plasma therapy have already been conducted in countries outside of Japan, but no conclusion has been reached with respect to the efficacy of convalescent plasma therapy, which is likely in part because of the heterogeneity of the types of target patients, interventions, and endpoints among trials. Actually, previous clinical trials on plasma therapy have shown inconsistent efficacy and are sometimes ineffective in COVID-19 patients with severe disease, which is due to unmeasured neutralizing antibody titer in the COVID-19 convalescent plasma. To improve this issue, in this study, we measure neutralizing activity of convalescent plasma before administration and provide the plasma with high neutralizing activity to the subjects. It is hoped that this study will further evidence to support the role of convalescent plasma therapy in COVID-19.

Effect of convalescent plasma therapy on mortality in moderate-to-severely Ill COVID-19 patients

IntroductionThe role of plasma therapy in the management of the COVID-19, pandemic has been speculated. However, in view of the varied response regarding its effectiveness from various multicenter studies, there is a need to conduct more single center population-specific studies. We, thus, aimed to assess the role of convalescent plasma therapy in COVID-19 patient management in a single -center. MethodsThis retrospective study was conducted using records of all COVID-19 patients who received plasma therapy over a period of 6 months in a dedicated COVID-19 hospital in Delhi. Information pertaining to transfusion, disease severity, associated comorbidities, the treatment given and patient outcome were recorded. Data was analyzed using SPSSv23. ResultsOf the141 patients who received plasma therapy, 62% were discharged after treatment. Mortality was found to be significantly higher in patients > 60 years of age (p < 0.001), those with severe COVID-19 infection (p < 0.05) and pre-existing renal disease (p < 0.05). The admission-transfusion interval was significantly correlated to mortality and was a sensitive parameter for predicting outcome at cut off value of < 5 days (p < 0.001). There was no significant association of mortality with patient blood group, plasma antibody levels or donor hemoglobin levels. ConclusionsWe report improvement and recovery in a large number of patients who received convalescent plasma within the first 5 days of hospitalization with moderate to severe disease. Further research to compare dosage and administration protocols to delineate role of CCP in survival of COVID-19 patients is needed before it isprematurely shelved.

Convalescent plasma as an adjunctive treatment for severe and critically ill COVID-19

Introduction: The historical treatment of convalescent plasma was successful against RNA viruses. However, the significance of COVID-19 convalescent plasma therapy has not been clinically proven consistently in most studies and the available data showed contradictory results so far. Our study aims to evaluate the role of convalescent plasma therapy as an adjunctive treatment for severe and critically ill COVID-19 patients.Methods: This study was an open-label, non-randomized comparative clinical trial that was conducted at Dr. Kariadi Hospital, Semarang, Indonesia. This study sample are hospitalized severe and critically ill COVID-19 patients were assigned with a 2:1 ratio to receive convalescent plasma and local standard of care. The primary outcome was the clinical status 30 days after the interventionResults: A total of 73 patients received convalescent plasma and 38 patients received local standards of care. Both of the groups had similar clinical ordinal scales (median was 5, p=0.65), while patients in the study groups had significantly higher SOFA scores and P/F ratio. The control group had a worse overall mortality rate (61.1% vs 18.4%) with a hazard ratio of 3.5 (95%CI, 2.1-5.9) compared to the study group. From the subgroup analysis, we found that patients in the study group without mechanical ventilation support had the best survival rate compared to other groups HR: 0.0047 (95%CI, 0.01-0.19). The clinical outcome 7 days after convalescent plasma infusion was also significantly improved in the study group (median baseline &amp; day-7, 5 &amp; 3, p&lt;0.001). From the multivariate analysis of therapeutic variables, convalescent plasma was the most significant variable for survival outcome (OR=0.089, 95%CI, 0.029-0.27; p&lt;0.001). There was one case of anaphylactic shock and was excluded.Conclusions: The convalescent plasma administration significantly improved clinical outcomes and overall survival rates compared to those who received local standards of care.

The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections.

Novel therapies for the treatment of COVID-19 are continuing to emerge as the SARS-Cov-2 pandemic progresses. PCR remains the standard benchmark for initial diagnosis of COVID-19 infection, while advances in immunological profiling are guiding clinical treatment. The SARS-Cov-2 virus has undergone multiple mutations since its emergence in 2019, resulting in changes in virulence that have impacted on disease severity globally. The emergence of more virulent variants of SARS-Cov-2 remains challenging for effective disease control during this pandemic. Major variants identified to date include B.1.1.7, B.1.351; P.1; B.1.617.2; B.1.427; P.2; P.3; B.1.525; and C.37. Globally, large unvaccinated populations increase the risk of more and more variants arising. With successive waves of COVID-19 emerging, strategies that mitigate against community transmission need to be implemented, including increased vaccination coverage. For treatment, convalescent plasma therapy, successfully deployed during recent Ebola outbreaks and for H1N1 influenza, can increase survival rates and improve host responses to viral challenge. Convalescent plasma is rich with cytokines (IL-1β, IL-2, IL-6, IL-17, and IL-8), CCL2, and TNFα, neutralizing antibodies, and clotting factors essential for the management of SARS-CoV-2 infection. Clinical trials can inform and guide treatment policy, leading to mainstream adoption of convalescent therapy. This review examines the limited number of clinical trials published, to date that have deployed this therapy and explores clinical trials in progress for the treatment of COVID-19.

Severe COVID-19 infection in a 32 weeks pregnant woman successfully treated with convalescent plasma therapy

From the beginning of corona virus disease 19(COVID-19) pandemic, there has been concern how to protect vulnerable group like pregnant women from severe acute respiratory syndrome corona virus 2(SARS-CoV-2). Historically, pregnant women experiences increased mortality during any pandemic situation. Pregnant women show almost the similar clinical features as that of non-pregnant adults with COVID-19 infection. Different systematic reviews have begun to focus light on pregnancy outcomes in COVID-19 patients, but knowledge is very limited and still the basis is case series and individual experiences. Apart from the scientifically proven therapeutic options used in COVID-19 such as steroid, low molecular weight heparin, the role of convalescent plasma therapy (CPT) has never been evaluated. We present a case of a pregnant woman of 32 weeks of conception, treated with CPT with favourable outcome in a private hospital of Dhaka, Bangladesh. BSMMU J 2021; 14 (COVID -19 Supplement): 64-66

Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

BackgroundData on convalescent plasma therapy (CPT) in patients of hematological malignancies with severe Covid-19 is scarce. ObjectiveTo study 14-day mortality in patients who received CPT. Patients & methodsRetrospective multicentre observational study conducted in 4 centres treating haematological malignancies across Delhi-national capital region. Total 33 haematological malignancies patients with severe Covid-19 who received CPT were analysed. ResultsThe median age of the study cohort was 62 years (18–80 years). Twenty one percent patients had 1 comorbidity, 18 % had 2 comorbidities and 6% patients had 3 and 5 comorbidities each. Twenty four patients were on active therapy. Sixty nine percent of patients required ICU stay. Twenty five patients received plasma therapy within 7 days (early) of diagnosis of Covid-19 infection. Median day of plasma infusion from date of diagnosis of Covid-19 infection was 4 days (range: 2–25 days). Patient who had early initiation of plasma therapy had shorter duration of hospitalisation (12.7 vs 24.3 days, p = 0.000). Overall mortality in the cohort was 45.5%. There was no effect of disease status, active therapy, presence of comorbidity on mortality. There was no difference in the mortality in patients receiving early vs late initiation of plasma therapy or in patients receiving one versus two plasma therapy. ConclusionsWe provide a large series of patients with hematological malignancies and role of CPT in this group.

Elucidating the pivotal role of convalescent plasma therapy in critically ill COVID-19 patients: A review.

World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic in March 2020. Currently almost every country in the world has reported cases with moderate to high mortality rates. The European Union (EU), the United States of America (USA) and the United Kingdom (UK) are the severely affected countries. Nevertheless, the WHO is very much concern about countries with weak health systems. The clinical characteristics of COVID-19 varies extensively, ranging from asymptomatic infections to severe as well as critical pneumonia with high mortality rates in the elderly and patients with co-morbid medical illness. Convalescent Plasma Therapy (CPT) has been successfully used in treating various viral disease outbreaks such as 1918 influenza pneumonia pandemic, poliomyelitis, measles, mumps, Machupo virus, Junin virus, Lassa virus, Ebola etc. High-titer specific antibodies maybe capable of binding to Coronavirus- 19 (CoV-19) and neutralize the viral particles, inhibit entry to uninfected cells, and trigger potent effector mechanisms such as complement activation as well as phagocytosis. Therefore, in most countries with very weak health systems with no Intensive Care Units (ICUs) or trained ICU physicians, early initiation of CPT for severely COVID- 19 patients may be rewarding. Therefore, solidarity control trials on CPT for COVID- 19 patients involving large number of patients are urgently needed.

Facts and challenges in convalescent plasma therapy in COVID-19

The present coronavirus disease 2019 (COVID-19) pandemic has brought the focus back onto the passive immunization potential of the Convalescent plasma. This however has many challenges as availability of recovered patients as donors, eligibility of recovered patients for convalescent plasma donation, Safety profile of convalescent plasma. Considering the lack of efficacious treatments for COVID 19 and the epidemic situation with high mortality rate, the evaluation of convalescent plasma therapy in COVID-19 is the need of the hour. In this article, the feasibility and challenges are discussed based on the literature published on role of convalescent plasma therapy in COVID-19. Based on the limited scientific data available, convalescent plasma transfusion (CPT) therapy in COVID-19 patients appears safe, clinically effective, and reduces mortality. However an ongoing clinical study at our Centre should give us a good direction to establish the efficacy of CPT to COVID-19 patients. Keywords: convalescent plasma therapy; COVID-19; coronavirus; SARS-CoV-2

Convalescent Plasma in the Treatment of Severe COVID-19: A Systematic Review and Meta-Analysis

Background:COVID-19 is a public health emergency of international concern. Its incidence rates and mortality are very high; however, so far, an effective drug treatment remains unknown. Based on the role of convalescent plasma therapy in previously identified viral pneumonias, patients with severe COVID-19 have been given this therapy. This systematic review and meta-analysis aimed to summarize the clinical evidence regarding the efficacy and safety of convalescent plasma therapy in the treatment of severe COVID-19.Methods:PubMed, Embase, Ovid, China Knowledge Network, China Biomedical, VIP Chinese Sci-tech Journal, Wanfang Database, and the International Clinical Trials Registry Platform were searched up to 21 June 2020, to identify clinical studies and registered trials on the use of convalescent plasma in the treatment of critically ill patients with COVID-19. Stata 13.0 was used to perform Meta-analysis. All records were screened as per the protocol eligibility criteria.Results:Nineteen clinical reports regarding convalescent plasma in the treatment of severe COVID-19 were included. Through systematic analysis, convalescent plasma was found to yield some efficacy on severe COVID-19 and had almost no obvious adverse reactions.Conclusion:Convalescent plasma therapy seems to yield some efficacy among patients with severe COVID-19 and almost no obvious adverse reactions were found. However, at present, the clinical evidence is insufficient, and there is an urgent need for support from high-quality clinical trial data.

Convalescent plasma for the treatment of patients with severe coronavirus disease 2019: A preliminary report.

BackgroundThe role of convalescent plasma therapy for patients with coronavirus disease 2019 (COVID‐19) is unclear.MethodsWe retrospectively compared outcomes in a cohort of critical COVID‐19 patients who received standard care (SC Group) and those who, in addition, received convalescent plasma (CP Group).ResultsIn total, 40 patients were included in each group. The median patient age was 53.5 years (interquartile range [IQR] 42–60.5), and the majority of patients required invasive ventilation (69, 86.2%). Plasma was harvested from donors after a median of 37 days (IQR 31–46) from the first positive severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) polymerase chain reaction (PCR) result and 26 days (IQR 21–32) after documented viral clearance; it was administered after a median of 10 days (IQR 9–10) from the onset of symptoms and 2.5 days (IQR 2–4) from admission to intensive care unit. The primary endpoint of improvement in respiratory support status within 28 days was achieved in 26 patients (65%) in the SC Group and 31 patients (77.5%) in the CP Group (p = .32). The 28‐day all‐cause mortality (12.5% vs. 2.5%; p = .22) and viral clearance (65% vs. 55%; p = .49) were not significantly different between the two groups. Convalescent plasma was not significantly associated with the primary endpoint (adjusted hazard ratio 0.87; 95% confidence interval 0.51–1.49; p = .62). Adverse events were balanced between the two study groups.ConclusionIn severe COVID‐19, convalescent plasma therapy was not associated with clinical benefits. Randomized trials are required to confirm our findings.

Role of convalescent plasma therapy in new Coronavirus disease (nCOVID-19): A review

Hitherto, there is no proper line of treatment for the new (nCOVID19). The development of unique antiviral drugs has taken precedence. Therapeutic antibodies () will be a significantly beneficial agent against nCOVID-19. Here the host immune responses to new discussed in this review provide strategy and further treatment and understanding of clinical interventions against nCOVID-19. Plasma therapy uses the antibodies found in the blood of people recovering (or convalesced) from an infection to treat infected patients. When an infection occurs, the body begins producing proteins specially made to kill the germ, called antibodies. Those antibodies coat specifically plasma in the blood of survivors, the yellow transparent liquid blood portion for months or even years. research assesses plasma use from Convalescent patients of infected with nCOVID-19 as a possible preventive treatment. But it is not yet recommended as a line of treatment, and it is used as a clinical trial in the new in Indian population.

General awareness about Covid-19 and the role of Convalescent plasma therapy in the treatment of Covid -19 among post graduate dental students - A KAP Survey

COVID-19, caused by SARS Cov2 virus is a global pandemic and a threat to the world population and economy. It can manifest with a broad spectrum of clinical symptoms ranging from asymptomatic cases to pneumonia or even fatality. One of the treatments suggested is convalescent plasma therapy. The study aims at assessing the general awareness about Covid-19 and knowledge about the role of Convalescent plasma therapy for treatment of -19 among post graduate dental students. The survey was conducted among postgraduate dental students through an online survey tool using google forms. The survey was conducted online among postgraduate dental students on the go with 19 and convalescent plasma therapy. total of 103 participant were included in the study. The responses were collected, tabulated and using SPSS software. The knowledge regarding -19 and the awareness about the usefulness of convalescent plasma was variable. Around 90% of the participants were aware of the effectiveness of convalescent plasma therapy. Advance training, proper PPE and training on handling the patients with any infectious disease should be dealt with in detail for reducing the spread from dental clinics and dentists.

Role of Convalescent Plasma Therapy in Successful Prevention and Treatment of Covid-19 Novel Corona Virus Critical Patients, In 2020 Global Pandemic

Ahsan Siddiqui, M.D, M.S.P.H (UK)* Author Affiliations Department of Quality Management & Patient Safety, General Directorate of Health, Saudi Arabia Received: March 14, 2020 | Published: June 11, 2020 Corresponding author: Ahsan Ali Siddiqui, Consultant Epidemiologist, Quality Management & Patient Safety, Department, General Directorate of Health, Riyadh Saudi Arabia DOI: 10.26717/BJSTR.2020.28.004618

Convalescent Plasma a Potential Therapy in Covid-19 Patients in Low Resource Setting: Rapid Review

Background: The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the time of writing, neither a cure nor a vaccine has been approved by the World health organization (WHO) for this disease. Given the fact that the severe acute respiratory syndrome coronavirus (SARS) and Middle East Respiratory Syndrome (MERS) viruses have a genetic sequencing similar to SARS-CoV-2, and since the use of convalescent plasma therapy (CP) has proved its efficacy in SARS and MERS virus infections, researchers are starting to focus more on it as a possible therapy for the COVID-19 disease. The main objective of this rapid review is to report and summarize the published evidence on the role of convalescent plasma therapy in the current COVID-19 pandemic.&#x0D; Method: The PICO method was used to establish the review question. Moreover, papers were gathered from PubMed and Google scholar, critically appraised for the best evidence. Piersons 5-component scheme was used to check the quality of the review papers.&#x0D; Results: After website screening: 10 papers in PubMed and 6 papers from Google scholars were retrieved. There were encouraging reports regarding the uses of CP in the previous viral outbreaks likes SARS and Ebola, yet there is still a doubt on the efficacy of this mode of therapy in the current COVID-19 pandemic.&#x0D; Conclusion: CP is a very promising treatment approach for COVID-19 patients; however, more clinical trials are required to validate the effectiveness of this therapy.&#x0D; Keywords: COVID-19, convalescent plasma therapy, SARS-CoV-2, therapy.

Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019.

Currently, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) has been reported in almost all countries globally, and no effective therapy has been documented for COVID-19 and the role of convalescent plasma therapy is unknown. In current study, 6 COVID-19 subjects with respiratory failure received convalescent plasma at a median of 21.5 days after first detection of viral shedding, all tested negative for SARS-CoV-2 RNA by 3 days after infusion, and 5 died eventually. In conclusion, convalescent plasma treatment can discontinue SARS-CoV-2 shedding but cannot reduce mortality in critically end-stage COVID-19 patients, and treatment should be initiated earlier.