Convalescent plasma transfusion for the treatment of COVID-19: Systematic review

Karthick Rajendran, Narayanasamy Krishnasamy, Jayanthi Rangarajan, Jeyalalitha Rathinam, Murugan Natarajan, Arunkumar Ramachandran, Karthick Rajendran, Narayanasamy Krishnasamy, Jayanthi Rangarajan, Jeyalalitha Rathinam, Murugan Natarajan, Arunkumar Ramachandran

Abstract

The recent emergence of coronavirus disease 2019 (COVID-19) pandemic has reassessed the usefulness of historic convalescent plasma transfusion (CPT). This review was conducted to evaluate the effectiveness of CPT therapy in COVID-19 patients based on the publications reported till date. To our knowledge, this is the first systematic review on convalescent plasma on clinically relevant outcomes in individuals with COVID-19. PubMed, EMBASE, and Medline databases were searched upto 19 April 2020. All records were screened as per the protocol eligibility criteria. We included five studies reporting CPT to COVID-19 patients. The main findings from available data are as follows: (a) Convalescent plasma may reduce mortality in critically ill patients, (b) Increase in neutralizing antibody titers and disappearance of SARS-CoV-2 RNA was observed in almost all the patients after CPT therapy, and (c) Beneficial effect on clinical symptoms after administration of convalescent plasma. Based on the limited scientific data, CPT therapy in COVID-19 patients appears safe, clinically effective, and reduces mortality. Well-designed large multicenter clinical trial studies should be conducted urgently to establish the efficacy of CPT to COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; convalescent plasma transfusion (CPT); neutralizing antibody.

Conflict of interest statement

The authors declare that there are no conflict of interests.

© 2020 Wiley Periodicals LLC.

Figures

Figure 1
Figure 1
PRISMA Flow chart of study selection. CPT, convalescent plasma transfusion

References

    1. World Health Organization . Coronavirus disease 2019 (COVID‐19) ‐ Situation Repor ‐ 90 (April 19, 2020). . Accessed April 19, 2020.
    1. World Health Organization . Clinical management of severe acute respiratory infection (SARI) when COVID‐19 disease is suspected. Interim guidance 13 March 2020. . Accessed April 18, 2020.
    1. Casadevall Arturo, Pirofski Liise‐anne. The convalescent sera option for containing COVID‐19. J Clin Invest. 2020;130(4):1545‐1548.
    1. Food and Drug Administration . Recommendations for Investigational COVID‐19 Convalescent Plasma, Content current as of: 04/13/2020. . Accessed April 18, 2020.
    1. Moher David, Shamseer Larissa, Clarke Mike, et al. Preferred reporting items for systematic review and meta‐analysis protocols (PRISMA‐P) 2015 statement. Syst Rev. 2015;4:1.
    1. Duan K, Liu B, Li C, et al. Effectiveness of convalescent plasma therapy in severe COVID‐19 patients. Proc Natl Acad Sci USA. 2020;117(17):9490‐9496.
    1. Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically Ill patients with COVID‐19 with convalescent plasma. JAMA. 2020;323(16):1582–1589. 10.1001/jama.2020.4783
    1. Zhang B, Liu S, Tan T, et al. Treatment with convalescent plasma for critically ill patients with SARS‐CoV‐2 infection. Chest. 2020;S0012‐3692(20):30571‐30577.
    1. Ahn JY, Sohn Y, Lee SH, et al. Use of convalescent plasma therapy in two covid‐19 patients with acute respiratory distress syndrome in Korea. J Korean Med Sci. 2020;35(14):e149.
    1. Ye Mingxiang, Fu Dian, Ren Yi, et al. Treatment with convalescent plasma for COVID‐19 patients in Wuhan, China. J Med Virol. 2020. 10.1002/jmv.25882
    1. Luke TC, Kilbane EM, Jackson JL, et al. Meta‐analysis: convalescent blood products for Spanish influenza pneumonia: a future H5N1 treatment? Ann Intern Med. 2006;145(8):599‐609.
    1. Soo YO, Cheng Y, Wong R, et al. Retrospective comparison of convalescent plasma with continuing high‐dose methylprednisolone treatment in SARS patients. Clin Microbiol Infect. 2004;10(7):676‐678.
    1. Hung IF, To KK, Lee CK, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis. 2011;52(4):447‐456.
    1. Zhou B, Zhong N, Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection. N Engl J Med. 2007;357(14):1450‐1451.
    1. World Health Organization . Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks. Updated 2014. Accessed April 18, 2020.
    1. Cheng Y, Wong R, Soo YO, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44‐46.
    1. Syal K. COVID‐19: herd immunity and convalescent plasma transfer therapy. J Med Virol. 2020. 10.1002/jmv.25870
    1. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: a systematic review. J Med Virol. 2020;92(5):479‐490.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe