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Recent Advances in Anti-Infective Drug Discovery

Editor-in-Chief

ISSN (Print): 2772-4344
ISSN (Online): 2772-4352

Research Article

Convalescent Plasma the Experience and Journey from Blockbuster to Incognito: A Single Centre Experience

Author(s): Gita Negi*, Daljit Kaur, Ashish Jain, Yatendra Kumar Mohan, Sushant Kumar Meinia, Pandeep Kaur, Prasan Kumar Panda, Deepjyoti Kalita and Ravikant

Volume 18, Issue 3, 2023

Published on: 19 December, 2022

Page: [188 - 196] Pages: 9

DOI: 10.2174/2772434417666220622140416

Price: $65

Abstract

Background: Convalescent plasma has been used to provide passive immunotherapy to patients with COVID-19 with a high level of safety. Very few efficacy studies were available, and due to COVID being a relatively new disease, its exact therapeutic role was unclear. This observational study on the impact of COVID convalescent plasma (CCP) on clinical outcomes attempts to evaluate the effectiveness of convalescent COVID-19 plasma therapy in the treatment of COVID-19 patients at the tertiary care center in the Uttarakhand state of India.

Methods: CCP was collected by plasmapheresis/whole blood from willing COVIDrecovered donors who underwent pre-donation testing including ABO and RhD grouping, mandatory blood screening tests for HIV, HBV, HCV, syphilis and Malaria, Haemoglobin estimation and COVID IgG assay. Hospitalized patients with severe COVID-19 pneumonia who received these CCP units were followed up and the outcome (Recovery/death) was observed.

Results: A total of 63 patients who received CCP were included in the study. Out of the total, 13 (20.7%) were females and 50 (79.3%) were males and their ages ranged from 24 to 80 years with a median age of 53 years. The period between the start of symptoms and hospitalization ranged from 1 to 14 days with an average duration of 4.7 days. Symptoms on presentation included Fever 53/63 (84.1%), Tachypnoea 60/63 (95.2%) and Cough 42/63 (66.7%). Among these patients, 22/63 (34.9%) were on non-invasive ventilation (NIV), 6/63 (9.5%) on non-rebreather mask (NRBM) and 32/63 (50.8%) were on Ventilator support. The infused convalescent plasma had a Mean IgG value of 57.3 AU with a range of (10-142 AU). A total of 37 (58.7%) patients were lost to COVID-19 infection and 26 (41.3%) were discharged from the hospital in a healthy state.

Conclusion: The use of convalescent plasma in addition to standard treatment in our study on patients with severe pneumonia due to COVID-19 did not demonstrate reduced mortality of COVID-19 patients amidst numerous variables. The results showed that the use of convalescent plasma as a treatment option in the present conditions needs a serious re-evaluation. Studies on a strictly defined recipient group and transfusion of CCP units, with adequate antibody titer and/or neutralization activity, must be analyzed for future works.

Keywords: Convalescent plasma, Covid 19, Pandemic, Recovery, Efficacy, Immunoglobulin

Graphical Abstract

[1]
Marano G, Vaglio S, Pupella S, et al. Convalescent plasma: New evidence for an old therapeutic tool? Blood Transfus 2016; 14(2): 152-7.
[http://dx.doi.org/10.2450/2015.0131-15] [PMID: 26674811]
[2]
Brunk, D. FDA OKs emergency use of convalescent plasma for seriously ill COVID-19 patients. Medscape, 2020. Available from: https://www.medscape.com/viewarticle/927716 (Accessed on June 02, 2022).
[3]
Network WB. Position Paper on Use of Convalescent Plasma, Serum of Immune Globuline Concentrates as an Element in Response to an Emerging Virus. Geneva, Switzerland: WHO Blood Regulators Network. 2017. 2017. Available from: https://www.who.int/bloodproducts/brn/2017 (Accessed on June 02, 2022).
[4]
National guidance to BTS in India in light of Covid-19 pandemic; national blood transfusion council, ministry of family and health welfare, government of india vide D.O No.: S-12016/99/2019- NACO(NBTC) (Second Interim Guidance). Available from: https://www.mohfw.gov.in/pdf/2ndNBTCGuidanceinLightofCOVID19Pandemic.pdf (Accessed on June 02, 2022).
[6]
ICMR Evidence Based Advisory to address inappropriate use of Convalescent Plasma in COVID-19 patients. Available from: https://www.icmr.gov.in/pdf/covid/techdoc/ICMR_ADVISORY_Convalescent_plasma_17112020_v1.pdf (Accessed on June 02, 2022).
[7]
Food and Drug Administration. EUA 26382: Emergency Use Authorization (EUA) Request. 2020. Available From: https://www.fda.gov/media/141480/download (accessed on January 26, 2022).
[8]
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): A randomised controlled, open-label, platform trial. Lancet 2021; 397(10289): 2049-59.
[http://dx.doi.org/10.1016/S0140-6736(21)00897-7] [PMID: 34000257]
[9]
Soto A, Krapp F, Vargas A, et al. Randomized clinical trial to evaluate safety and efficacy of convalescent plasma use among hospitalized patients with COVID-19 (PERUCONPLASMA): A structured summary of a study protocol for a randomized controlled trial. Trials 2021; 22(1): 342.
[http://dx.doi.org/10.1186/s13063-021-05189-6] [PMID: 34001174]
[10]
Luke TC, Kilbane EM, Jackson JL, Hoffman SL. Meta-analysis: Convalescent blood products for Spanish influenza pneumonia: A future H5N1 treatment? Ann Intern Med 2006; 145(8): 599-609.
[http://dx.doi.org/10.7326/0003-4819-145-8-200610170-00139] [PMID: 16940336]
[11]
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): 447-56.
[http://dx.doi.org/10.1093/cid/ciq106] [PMID: 21248066]
[12]
Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks. Interim Guidance for National Health Authorities and Blood Transfusion Services Version 10 September 2014.
[13]
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: A systematic review and exploratory meta-analysis. J Infect Dis 2015; 211(1): 80-90.
[http://dx.doi.org/10.1093/infdis/jiu396] [PMID: 25030060]
[14]
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]
[15]
Zhang B, Liu S, Tan T, et al. Treatment with convalescent plasma for critically ill patients with SARSCoV-2 infection. Chest 2020; 158(1): e9-13.
[http://dx.doi.org/10.1016/j.chest.2020.03.039] [PMID: 32243945]
[16]
Joyner MJ, Bruno KA, Klassen SA, et al. Safety update: COVID-19 convalescent plasma in 20,000 hospitalized patients. Mayo Clin Proc 2020; 95(9): 1888-97.
[http://dx.doi.org/10.1016/j.mayocp.2020.06.028] [PMID: 32861333]
[17]
Joyner MJ, Senefeld JW, Klassen SA, et al. Effect of convalescent plasma on mortality among hospitalized patients with COVID-19: Initial three-month experience. Medrxiv, 2020. https://www.medrxiv.org/content/10.1101/2020.08.12
[http://dx.doi.org/10.1101/2020.08.12.20169359]
[18]
Simonovich VA, Burgos Pratx LD, Scibona P, et al. A randomized trial of convalescent plasma in Covid-19 severe pneumonia. N Engl J Med 2021; 384(7): 619-29.
[http://dx.doi.org/10.1056/NEJMoa2031304] [PMID: 33232588]
[19]
Agarwal A, Mukherjee A, Kumar G, Chatterjee P, Bhatnagar T, Malhotra P. Convalescent plasma in the management of moderate COVID-19 in adults in India: Open label phase II multicentre randomised controlled trial (PLACID Trial). BMJ 2020; 371: m3939.
[20]
Central Drugs Standard Control Notice. Available from: https://cdsco.gov.in/opencms/open-cms/system/modules/CDSCO.WEB/elements/download_file_ division.jsp?num_id=NjA0Mw== Accessed on 25Aug 2020.
[21]
Li L, Zhang W, Hu Y, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: A randomized clinical trial. JAMA 2020; 324(5): 460-70.
[http://dx.doi.org/10.1001/jama.2020.10044] [PMID: 32492084]
[22]
Tiwari AK, Negi G, Jaiswal RM, et al. Correlation of sample-to-cut-off ratio of anti-SARS-CoV-2 IgG antibody chemiluminescent assay with neutralization activity: A prospective multi-centric study in India. ISBT Sci Ser 2021; 16(4): 269-75.
[http://dx.doi.org/10.1111/voxs.12644] [PMID: 34548879]
[23]
Park H, Tarpey T, Liu M, et al. Development and validation of a treatment benefit index to identify hospitalized patients with COVID-19 who may benefit from convalescent plasma. JAMA Network Open 2022; 5(1): e2147375.
[http://dx.doi.org/10.1001/jamanetworkopen.2021.47375]

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