Published by Dr. Ruchika Goel on Tuesday, June 16, 2020 in Blog
presentation objectives
- To trace the historical role of Convalescent Plasma therapy as an emergency application in times of epidemics and critically review the data showing current usage, safety and efficacy in SARS-COV-2.
- To outline the collaborative community effort in successfully setting up a regional convalescent plasma program: the combined patient/donor, hospital and blood center initiative.
- Discuss the current treatment protocols and standardized workflow.
Watch the presentation below to learn more.
Convalescent plasma is the yellow liquid that is separated from blood donated by a patients who has recently recovered from an infection. Convalescent plasma is being investigated for the treatment of severe COVID-19 infection. It is hypothesized that antibodies to SARS-CoV-2 (the virus that causes COVID-19) in convalescent plasma may reduce severity of infection and reduce mortality in other sick patients who could not adequately develop this antibody response themselves.
Given the dearth of effective treatments for COVID-19, convalescent plasma has gained serious attention. While this treatment is not a cure, it might help alleviate the symptoms patients experience with COVID-19. Recent promising data from China supports convalescent plasma use for early recovery of some of the sickest patients. It is important to note however, that majority of these data are observational and warrant cautious optimism. This approach requires evaluation in randomized clinical trials and initial clinical trial data on efficacy of CCP (although very prelim) looks promising. Further investigation is still necessary to determine if convalescent plasma might significantly shorten the 1) duration of illness, 2) reduce disease related morbidity, or 3) prevent mortality associated with COVID-19. Given this is a huge public health emergency, as a huge support, FDA has facilitated the access to COVID-19 convalescent plasma for use in patients who have serious or life-threatening COVID-19 infections as a single patient emergency Investigational New Drug Applications for individual patients.
Use of convalescent plasma has previously and more recently been studied in outbreaks of other respiratory infections, including the 2009-2010 H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic with varying degree of success. However, the idea of using blood (effective component is plasma) from disease survivors, also known as convalescent-plasma therapy, dates back to actually the late 19th or early 20th century. Doctors have transfused the blood of recovered patients into those who continued to be sick with the 1918 Spanish flu, measles, polio, chickenpox, and Ebola—all to varying degrees of success.
It is important to note that this potential therapeutic option can be a two-edged sword as convalescent plasma comes with all baseline and inherent risks with any plasma transfusion. Plasma transfusions are associated with adverse events ranging from mild fever and an allergic reaction like hives to life-threatening anaphylaxis, transfusion-related acute lung injury, and transfusion associated circulatory overload in patients with underlying cardiorespiratory disorders. However, safety data from first 20,000 products transfused nationally has been very promising with CCP being well tolerated with minimal side effects. There is also a very rare residual risk of infectious disease transmission like HIV and HCV (<1 per million transfusion events). There is no evidence of transfusion transmission of coronavirus through any blood products. Lastly, even if useful this will require ramping up of testing to find those who recovered and their goodwill to donate blood.
Tags
- convalescent plasma
- covid-19
- hospitals