Efficacy and safety of convalescent plasma therapy in patients with COVID-19: arapid review of case series



David Dwi Putera(1), Mardiah Suci Hardianti(2*)

(1) Siloam Hospitals Labuan Bajo, Nusa Tenggara Timur
(2) Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020.Currently, there is no established treatment to combat this potentially fatal disease. Convalescent plasma (CP) therapy has a strong scientific basis and historical perspective to treat previous viral infections such as Ebola, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). The aim of this review was to evaluate the efficacy and safety of convalescent plasma CP therapy in patients with COVID-19.We searched for every available study from major databases (CENTRAL, MEDLINE via Ovid, EMBASE) through 20th April 2020. We independently screened, extracted, assessed the risk of bias, analyzed the data using SPSS version 26, and narratively summarized the data. For the outcomes, we wanted to evaluate the changes of clinical parameters, radiological appearance, pulmonary function, the titer of neutralizing antibody, viral load, the disappearance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA, and adverse events.We found five case series from our literature searching. The overall methodological quality of the case series was moderate. We included 27 patients, and all patients received CP transfusion. All patients experienced improvement of clinical symptoms and pulmonary lesions after receiving 200 to 2400 mL (median 200 mL) of CP transfusion. All patients in reported studies had negative results of reverse transcriptase-polymerase chain reaction(RT-PCR) after 1 to 26 days of transfusion (median 3 days). There was one non-life threatening adverse event reported after CP transfusion (facial red spot). In conclusion, CP therapy in COVID-19 patients showed promising results as it improved clinical symptoms and parameters, and it is well-tolerated based on our included studies. However, further expanded clinical trials with better designs are still required to evaluate the efficacy of this treatment although suchidea will be quite challenging to be conducted in the era of an epidemic.


Keywords


COVID-19; onvalescent plasma; therapy; systematic review; side effect;

Full Text:

PDF


References

  1. Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl) 2020; 33(9):1015-24. https://doi.org/10.1097/CM9.0000000000000722
  2. World Health Organization.Coronavirus disease 2019 (COVID-19) Situation Report – 77. Geneva: World Health Organization, 2020.
  3. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. NEngl J Med 2020; 382(8):727-33. https://doi.org/10.1056/NEJMoa2001017
  4. Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infec Dis 2020; 20(4):398-400. https://doi.org/10.1016/S1473-3099(20)30141-9
  5. Beeching NJ, Fletcher TE, Fowler R. Coronavirus disease 2019 (COVID-19). BMJ Best Practice 2020. https://doi.org/bestpractice.bmj.com/topics/en-gb/3000168
  6. Guan W, Ni Z, Hu Y, Liang W, Ou C, Ou J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 82:1708-20 https://doi.org/10.1056/nejmoa2002032
  7. Bloch EM, Shoham S, Casadevall A, Sachais BS, Shaz B, Winters JL, et al. Deployment of convalescent plasma for the prevention and treatment of COVID-19. JClin Invest 2020; 138745. https://doi.org/10.1172/JCI138745
  8. Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA 2020; 323(16):1582-9. https://doi.org/10.1001/jama.2020.4783
  9. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Geneva: World Health Organization, 2020.
  10. Joanna Briggs Institute. Critical appraisal checklist for case series. Available from: http://joannabriggs. org/research/critical-appraisal-tools.
  11. Pei S, Yuan X, Zhang ZZ, Yao RR, Xie Y, Shen MM, et al. Convalescent plasma to treat COVID-19: Chinese strategy and experiences. medRxiv 2020. https://doi.org/10.1101/2020.04.07.20056440
  12. Ahn JY, Sohn Y, Lee SH, Cho Y, Hyun JH, Baek YJ, et al. Use of convalescent plasma therapy in two COVID-19 patients with acute respiratory distress syndrome in Korea. JKorean Med Sci 2020; 35(14):e149. https://doi.org/10.3346/jkms.2020.35.e149
  13. Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. PNAS 2020; 117(17):9490-6. https://doi.org/10.1073/pnas.2004168117
  14. Ye M, Fu D, Ren Y, Wang F, Wang D, Zhang F, et al. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. JMed Virol 2020. https://doi.org/10.1002/jmv.25882
  15. 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; S0012-3692(20)30571-7.
  16. Casadevall A, Pirofski LA. The convalescent sera option for containing COVID-19. J ClinInvest 2020; 130(4):1545-8. https://doi.org/10.1172/JCI138003
  17. Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis 2005; 24(1):44-6. http://doi.org/10.1007/s10096-004-1271-9
  18. Hung IFN, To KKW, Lee CK, et al. Hyperimmune IV immunoglobulin treatment: a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A(H1N1) infection. Chest 2013; 144(2):464-73. https://doi.org/10.1378/chest.12-2907
  19. Focosi D, Tang J, Anderson A, Tuccori M. Convalescent plasma therapy for Covid-19: state of the art. Preprints2020, 2020040097 https://doi.org/10.20944/preprints202004.0097.v1
  20. Zand M, Wang J. Potential mechanisms of age related severity of COVID-19 infection: implications for vaccine development and convalescent serum therapy. Preprints 2020. http://doi.org/10.31219/osf.io/f3pze




Article Metrics

Abstract views : 600 | views : 445




Copyright (c) 2020 Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

View My Stats

 

Creative Commons License
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://jurnal.ugm.ac.id/bik/.