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Coronaviruses

Editor-in-Chief

ISSN (Print): 2666-7967
ISSN (Online): 2666-7975

Systematic Review Article

Safety and Efficacy of Convalescent Plasma Therapy for the Management of COVID-19: A Systematic Review

Author(s): Sitaram Khadka*, Mohammad Saleem, Dhan Bahadur Shrestha and Pravash Budhathoki

Volume 2, Issue 6, 2021

Published on: 03 December, 2020

Article ID: e130621188718 Pages: 10

DOI: 10.2174/2666796701999201204114525

Price: $65

Abstract

Introduction: Till date, no proven therapy exists for coronavirus disease (COVID-19), though different types of treatment modalities are being practiced around the world. Different studies regarding Convalescent Plasma (CP) therapy from COVID-19 recovered donors have shown favorable results with fewer adverse consequences. In this systematic review, we aimed to determine the safety and efficacy of CP as a therapy for COVID-19.

Materials and Methods: The English language databases of PubMed, Google Scholar, and ScienceDirect were searched up to 22 May 2020. Eligibility for inclusion, risk of bias assessment, and data extraction from the included studies were determined and a narrative synthesis was conducted.

Results: A total of 12 studies were selected for review. The overall risks of bias were moderate to high. The results revealed significance in the initiation of CP therapy during the early stages of viremia from a safety and efficacy viewpoint. The patients also received concomitant drugs and other supportive therapies in most cases. Some cases of mortality were reported in 3 studies. Viral loads were documented to decrease and become negative in 8 studies within 3-26 days post-transfusion. The improvement in clinical symptoms following CP therapy was demonstrated in 9 studies. Most of the patients experienced very few adverse effects.

Conclusion: The rational practice of CP therapy based on a risk-benefit judgment can prove to be an efficacious therapeutic option as a last resort until the approval of any therapeutic and/or prophylactic agent(s). The substantial randomized controlled trials (RCTs) are necessary to validate the effectiveness of such therapy.

Keywords: Convalescent plasma therapy, COVID-19, efficacy, risk-benefit judgment, safety, treatment modalities.

[1]
Coronavirus (COVID-19). 2020. Available from: https://who.sprinklr.com/
[2]
Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. WHO 2020.
[3]
CDC. Coronavirus disease 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
[4]
Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019-new coronavirus epidemic: Evidence for virus evolution. J Med Virol 2020; 92(4): 455-9.
[http://dx.doi.org/10.1002/jmv.25688] [PMID: 31994738]
[5]
Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res 2020; 24: 91-8.
[http://dx.doi.org/10.1016/j.jare.2020.03.005] [PMID: 32257431]
[6]
World Health Organization declares COVID-19 a “Pandemic.” Here’s what that means. Time. 2020. Available from: https://time.com/5791661/who-coronavirus-pandemic-declaration/
[7]
Cunningham AC, Goh HP, Koh D. Treatment of COVID-19: Old tricks for new challenges. Crit Care 2020; 24(1): 91.
[http://dx.doi.org/10.1186/s13054-020-2818-6] [PMID: 32178711]
[8]
Tang W, Cao Z, Han M, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: Open label, randomised controlled trial. BMJ 2020; 369: m1849.
[http://dx.doi.org/10.1136/bmj.m1849] [PMID: 32409561]
[9]
9. FDA news release. FDA issues emergency use authorization for convalescent plasma as potential promising COVID-19 treatment, another achievement in administration’s fight against pandemic. 2020. Available from: https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment#:~:text=Today%2C
[10]
Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: Observational comparative study using routine care data. 2020. Available from: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment
[11]
FDA news release. Coronavirus (COVID-19) update: FDA issues emergency use authorization for potential COVID-19 Treatment. 2020. Available from: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment
[12]
Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: A randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020.
[13]
Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis 2020; 20(4): 398-400.
[http://dx.doi.org/10.1016/S1473-3099(20)30141-9] [PMID: 32113510]
[15]
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): 9490-6.
[http://dx.doi.org/10.1073/pnas.2004168117] [PMID: 32253318]
[16]
Casadevall A, Pirofski LA. The convalescent sera option for containing COVID-19. J Clin Invest 2020; 130(4): 1545-8.
[http://dx.doi.org/10.1172/JCI138003] [PMID: 32167489]
[17]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Ann Intern Med 2009; 151(4)
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00136] [PMID: 19622512]
[18]
Ye M, Fu D, Ren Y, et al. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol 2020.
[http://dx.doi.org/10.1002/jmv.25882] [PMID: 32293713]
[19]
Anderson J, Schauer J, Bryant S, Graves CR. The use of convalescent plasma therapy and remdesivir in the successful management of a critically ill obstetric patient with novel coronavirus 2019 infection: A case report. Case Rep Womens Health 2020; 27
[http://dx.doi.org/10.1016/j.crwh.2020.e00221] [PMID: 32426243]
[20]
Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with covid-19 with convalescent plasma. JAMA 2020; 323(16): 1582-9.
[http://dx.doi.org/10.1001/jama.2020.4783] [PMID: 32219428]
[21]
Zhang B, Liu S, Tan T, Huang W, Dong Y, Chen L, et al. Treatment with convalescent plasma for critically ill patients with SARS-CoV-2 infection. Chest 2020.
[22]
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)
[http://dx.doi.org/10.3346/jkms.2020.35.e149] [PMID: 32281317]
[23]
Zeng Q L, Yu Z J, Gou J J, Li G M, Ma S H, Zhang G F, et al. Effect of convalescent plasma therapy on viral shedding and survival in COVID-19 patients. J Infect Dis 2020.
[24]
Salazar E, Perez K K, Ashraf M, Chen J, Castillo B, Christensen P A, et al. Treatment of covid-19 patients with convalescent plasma in houston, texas. medRxiv 2020.
[25]
Joyner M, Wright R S, Fairweather D, Senefeld J, Bruno K, Klassen S, et al. Early safety indicators of covid-19 convalescent plasma in 5,000 patients. medRxiv 2020.
[26]
Tan L, Kang X, Zhang B, Zheng S, Liu B, Yu T, et al. A special case of COVID-19 with long duration of viral shedding for 49 days. medRxiv 2020.
[27]
Pei S, Yuan X, Zhang Z Z, Yao R R, Xie Y, Shen M M, et al. Convalescent plasma to treat covid-19: Chinese strategy and experiences. medRxiv 2020.
[28]
Yang X, Sui Y, Liu F, et al. Clinical characteristics and convalescent plasma therapy in severe and critically ill COVID-19 patients. 2020. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3576894
[29]
ClinicalTrials.gov. NIH US national library of medicine. 2020. Available from: https://clinicaltrials.gov/ct2/results?term=covid+19+convalescent+plasma&Search=Search
[30]
Ko JH, Seok H, Cho SY, et al. Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: A single centre experience. Antivir Ther 2018; 23(7): 617-22.
[http://dx.doi.org/10.3851/IMP3243] [PMID: 29923831]
[31]
Zhang L, Pang R, Xue X, et al. Anti-SARS-CoV-2 virus antibody levels in convalescent plasma of six donors who have recovered from COVID-19. Aging (Albany NY) 2020; 12(8): 6536-42.
[http://dx.doi.org/10.18632/aging.103102] [PMID: 32320384]

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