Severe refractory COVID-19 patients responding to convalescent plasma; A case series (original) (raw)
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Effectiveness of convalescent plasma therapy in severe COVID-19 patients
Proceedings of the National Academy of Sciences, 2020
Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to im...
Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma
The American Journal of Pathology, 2020
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has spread globally, and no proven treatments are available. Convalescent plasma therapy has been used with varying degrees of success to treat severe microbial infections for >100 years. Patients (n Z 25) with severe and/or life-threatening COVID-19 disease were enrolled at the Houston Methodist hospitals from March 28, 2020, to April 14, 2020. Patients were transfused with convalescent plasma, obtained from donors with confirmed severe acute respiratory syndrome coronavirus 2 infection who had recovered. The primary study outcome was safety, and the secondary outcome was clinical status at day 14 after transfusion. Clinical improvement was assessed on the basis of a modified World Health Organization six-point ordinal scale and laboratory parameters. Viral genome sequencing was performed on donor and recipient strains. At day 7 after transfusion with convalescent plasma, nine patients had at least a one-point improvement in clinical scale, and seven of those were discharged. By day 14 after transfusion, 19 (76%) patients had at least a one-point improvement in clinical status, and 11 were discharged. No adverse events as a result of plasma transfusion were observed. Whole genome sequencing data did not identify a strain genotype-disease severity correlation. The data indicate that administration of convalescent plasma is a safe treatment option for those with severe COVID-19 disease.
Convalescent plasma therapy for COVID-19: a review of old therapy against new disease
International Journal of Basic & Clinical Pharmacology
Currently, novel coronavirus disease 2019 (COVID-19) is a big threat to global health which has revived the potential beneficial effect of ancient convalescent plasma therapy (CPT). This review was conducted to evaluate the effectiveness and adverse drug reactions associated with convalescent plasma therapy in COVID-19 patients, based on articles available to date. PubMed, Google Scholar, Cochrane library, and Hinari databases were searched until 15th September 2020. Every country across the globe today is encountered with a virus that has impacted millions of lives today and for generations to come. Nonetheless recommended antiviral drugs and vaccines are not evident and specified for novel coronavirus disease. This is now very well known that scientists and medical experts across the world are vigilant about recommending the use of CPT and call it an investigational treatment that may help in assisting recovery. The World health organization has perpetuated that there is not enoug...
Effectiveness of Convalescent Plasma Therapy in COVID-19 Patients
Pakistan Postgraduate Medical Journal
Background: COVID-19 is an infectious disease caused by a newly identified strain of coronavirus (SARS-CoV-2). This strain is responsible for respiratory infections in humans. Objective: The objective of this study was to analyze the clinical efficacy and safety of convalescent plasma (CP) therapy in coronavirus disease 2019 (COVID-19) cases. Methodology: This was an experimental trial of COVID-19 patients treated with convalescent plasma (CP) therapy, these patients were admitted in Lahore General Hospital, Lahore, Pakistan during April 24 to august 24, 2021. Results: Pearson correlation was applied to extract the efficacy of convalescent plasma therapy (CP). A p-value ≤0.05 was considered significant. 16 out of 20 patients (80%) were completely recovered from COVID-19. Conclusion: Convalescent plasma (CP) proved to be an effective and safe therapy for confirmed cases of COVID-19. However, two critically ill patients died.
A review of COVID-19 convalescent plasma use in COVID-19 with focus on proof of efficacy
Immunologic Research, 2021
Convalescent plasma (CP) therapy is rapidly becoming an established consideration in the treatment of COVID-19 patients though there is a need to critically review this area for proof of efficacy. Neutralizing antibodies (NAb) present in CP generated in response to SARS-CoV-2 infection directed against the receptor-binding domain (RBD) of the spike protein are considered to play main role in viral clearance. CP infusion may also help in the modulation of immune response by its immunomodulatory effect. The FDA allows for administration of CP to COVID-19 patients. The present published literature in COVID-19 is limited to case series and randomised controlled trial where plasma therapy was used in moderate, severe and critically ill patients. Though multiple uncertainties exist regarding to its efficacy, appropriate donor selection and NAb titres, the efficacy data of CP use inCOVID-19 is limited having shown hope with early and severe to critically ill COVID-19 patients.
Indian Journal of Forensic Medicine & Toxicology, 2020
COVID-19 is a new disease caused by SARS-CoV-2 with an increasing number of cases. until now, no specific vaccine or antiviral therapy regimen has yet been found. A therapy that has been known for approximately a century ago called convalescent plasma therapy has been discussed again as an effective and safe therapy for COVID-19 patients. Conduct a literature review of scientific studies related to the effectiveness and safety of convalescent plasma as a therapy for COVID-19 patients. Convalescent plasma has proven to be effective because it can improve the clinical condition felt by patient, prevent the entry of viruses into cells and inhibit the virus replication. This therapy is also proven to have no harmful effects, so it is safe to be performed by paying attention to certain things such as conditions that must be fulfilled by the donors.
Convalescent plasma therapy in patients with COVID-19
Transfusion and Apheresis Science, 2021
There are currently no licensed vaccines or therapeutics for COVID-19. Anti-SARS CoV-2 antibody-containing plasmas, obtained from the recovered individuals who had confirmed COVID-19, have been started to be collected using apheresis devices and stored in blood banks in some countries in order to administer to the patients with COVID-19 for reducing the need of intensive care and the mortality rates. Therefore, in this review, we aim to point out some important issues related to convalescent plasma (CP) and its use in COVID-19. CP may be an adjunctive treatment option to the anti-viral therapy. The protective effect of CP may continue for weeks and months. After the assessment of the donor, 200-600 mL plasma can be collected with apheresis devices. The donation interval may vary between countries. Even though limited published studies are not prospective or randomized, until the development of vaccines or therapeutics, CP seems to be a safe and probably effective treatment for critically ill patients with COVID-19. It could also be used for prophylactic purposes but the safety and effectiveness of this approach should be tested in randomized prospective clinical trials.
Journal of Medical Virology, 2020
Background The role of convalescent plasma therapy for patients with Coronavirus Disease 2019 (COVID-19) is unclear. Methods We 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). Results Forty patients were included in each group. The median patient age was 53.5 years [interquartile range (IQR) 42-60.5], and the majority required invasive ventilation (69, 86.2%). Plasma was harvested from donors after a median of 37 days (IQR 31-46) from the first positive SARS-CoV-2 PCR result, and 26 days (IQR 21-32) after documented viral clearance; and was administered after a median of 10 days (IQR 9-10) from onset of symptoms and 2.5 days (IQR 2-4) from admission to ICU. The primary endpoint of improvement in respiratory support status within 28 days was achieved in 26 (65%) in the SC Group, and 31 (77.5%) in the CP Group (P 0.32). All-cause mortality at 28 days (12.5% versus 2.5%, P 0.22), and viral clearance (65% versus 55%, P 0.49) 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 0.62). Adverse events were balanced between the two study groups. Conclusion In severe COVID-19, convalescent plasma therapy was not associated with clinical benefits. Randomized trials are required to confirm our findings.
Convalescent plasma therapy for COVID-19
The discovery of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the outbreak of coronavirus disease 2019 (COVID-19) are causing public health emergency. A handful of literatures have summarized its clinical and radiologic features, whereas therapies for COVID-19 are rather limited. In order to evaluate the efficacy of convalescent plasma therapy in COVID-19 patients, we did this timely descriptive study. 6 laboratory confirmed COVID-19 patients were enrolled and received the transfusion of ABO-compatible convalescent plasma. The efficacy of this intervention was determined by the alleviation of symptoms, changes in radiologic abnormalities and laboratory tests. No obvious adverse effect observed during the treatment. Transfusion of convalescent plasma led to a resolution of ground glass opacities (GGOs) and consolidation in patient #1, #2, #3, #4 and #6. In patient #1 and #5 who presented with SARS-CoV-2 in throat swab, convalescent plasma therapy elicited an elimination of virus. Serologic analysis indicated an immediate increase in anti-SARS-CoV-2 antibody titers in patient #2 and #3, but not in patient #1. This study indicates that convalescent plasma therapy is effective and specific for COVID-19. This intervention has a special significance for eliminating SARS-CoV-2 and is believed to be a promising state-of-art therapy during COVID-19 pandemic crisis.
Convalescent Plasma Therapy for COVID-19: Current Status and Future Directions
Journal of Neuroanaesthesiology and Critical Care
The ongoing pandemic of coronavirus disease 2019 (COVID-19) has triggered a global health crisis probably due to a lack of a reliable cure till date. Several clinical trials are ongoing, but initial results have not been overly promising. Convalescent plasma (CP), which refers to plasma collected from individuals recovered from an illness and developed antibodies against the pathogen, is also being proposed as a therapeutic option for COVID-19 treatment in severe cases to achieve short-term immunity against the virus. Use of CP is not new, and it has been used in various outbreaks over the past century, ranging from the Spanish influenza outbreak in 1918 to the recent Middle East respiratory syndrome (MERS). However, data available on its use in COVID-19 patients is limited. Use of CP so far is restricted to a “rescue therapy” and needs further trials to assess its possible use in other situations (prevention, postexposure prophylaxis) and patient populations (considering age and co...