Blood derivative therapy

There are three main components manufactured from whole blood: red blood cells (RBCs), plasma, and platelets. Plasma contains a multitude of different proteins, peptides, and biologic substances. Approximately 53 million liters of plasma was collected in the United States in 2019. Following collection, plasma is frozen and manufactured into plasma-derived medicinal products (PDMPs). During the manufacture process, several thousand plasma units are pooled for Cohn fractionation, which is based upon cold ethanol precipitation of proteins. The PDMPs are further prepared using ion exchange or affinity chromatography and additional steps to inactivate and remove infectious diseases such as viruses. Almost 20 different therapeutic plasma proteins are purified from plasma via these multi-step manufacturing processes. Interestingly, the demand for pharmaceutical plasma products, particularly intravenous immunoglobulin (IVIG) products, has been increasing. The manufacture and therapeutic role of blood derivatives particularly immunoglobulin therapy, Rh immunoglobulin (RhIG), COVID-19 convalescent plasma (CCP) and hyperimmune globulins, albumin, clotting factors, fibrin sealants, and platelet rich plasma will be described.Copyright © 2022 AME Publishing Company. All Rights Reserved.

The therapeutics, based on virus specific antibodies, for special prophylactic and current of COVID-19

The analyses of effectiveness of medical means of protection based on virus specific antibodies, intended for special prophylactic and current of COVID-19 is conducted. The plasma of patients, obtained from the blood takes the leading part among these prepares. It is concluded, that convalescents plasma, containing virus neutralizing antibodies, may be used for emergency prevention or in the early stages of the disease. A risk group, that primarily needs in such drugs for special prophylactics, is medical workers. The other prepares, based on virus specific antibodies, including purified prepares of monoclonal antibodies, that may have certain advantages to convalescent's plasma due to their safety and high activity, due to complexity of their production and presumably high cost are unlikely to be available in the near future for mass use in the practice of medicine. The use of convalescents plasma for the prevention and treatment of COVID-19.can be based on the experience of their application in specialized medical centers and summarizing data from randomized clinical trials.Copyright © 2021 Moscow State University of Psychology and Education. All right reserved.

Current therapeutic strategies and possible effective drug delivery strategies against COVID-19.

COVID-19 pandemic is the biggest global crisis. The frequent mutations in coronavirus to generate new mutants is of major concern. The pathophysiology of SARS-CoV-2 infection has been well studied to find out suitable molecular targets and candidate drugs for effective treatment. FDA-recommended etiotropic therapies are currently followed along with mass vaccination. The drug delivery system and the route of administration have a great role to enhance the efficacy of therapeutic agents and vaccines. Since COVID-19 primarily infects the lungs in the affected individuals, pulmonary administration may be the best possible route for the treatment of COVID-19. Liposomes, solid lipid nanoparticles, polymeric nanoparticles, porous microsphere, dendrimers, and nanoparticles encapsulated microparticles are the most suitable drug delivery systems for targeted drug delivery. The solubility, permeability, chemical stability, and biodegradability of drug molecules are the key factors for the right selection of suitable nanocarriers. The application of nanotechnology has been instrumental in the successful development of mRNA, DNA and subunit vaccines, as well as the delivery of COVID-19 therapeutic agents.

Use of convalescent plasma therapy in hospitalised adult patients with non-critical COVID-19: a focus on the elderly from Hungary.

Convalescent plasma therapy might be a feasible option for treatment of novel infections. During the early phases of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, several promising results were published with convalescent plasma therapy, followed by more disappointing findings of randomised controlled trials. In our single-centre, open-label, prospective, cohort study, we assessed the findings of 180 patients treated with convalescent plasma during the first four waves of the pandemic in Hungary. The primary outcome was all-cause mortality; secondary outcomes were clinical improvement and need for intensive care unit admission by day 28. Subgroup analysis comparing elderly and non-elderly (less than 65 years of age) was performed. Twenty (11.4%) patients died by day 28, at significantly higher rates in the elderly subgroup (3 vs. 17, p < 0.01). One hundred twenty-eight (72.7%) patients showed clinical improvement, and 15 (8.5%) were transferred to the intensive care unit until day 28. Non-elderly patients showed clinical improvement by day 28 in significantly higher rates (improvement 74 vs. 54, no improvement 15 vs. 11, worsening or death 4 vs. 18 patients, p < 0.01). In conclusion, we found similar clinical outcome results as randomised controlled trials, and the impact of risk factors for unfavourable clinical outcomes among patients in the elderly population.

Current Advances in Novel SARS-CoV-2 Disease (COVID-19) Treatment and Intervention Strategies

Background: During the eleven months of the novel SARS-CoV-2 disease (COVID-19) outbreak in China and its global spread, there is a remarkable understanding of its epidemiology, pathobiol-ogy, and clinical management strategies. While countering a heavy toll on health and the economy, world's regional authorities are enforcing safety guidelines and providing patient care. Currently, there is no globally approved treatment or intervention for COVID-19. Method(s): A structured online literature search for peer-reviewed articles was conducted on PubMed, Europe PMC, Google, WHO, CDC, FDA, and ClinicalTrials portals, using phrases such as COVID-19 treatment and intervention, COVID-19 drugs and COVID-19 vaccines. Result(s): Analysis of the retrieved data showed that as a part of 'Solidarity Clinical Trials', hundreds of treatment and intervention strategies, including antiviral drugs, cytokine antagonists, convalescent plasma therapy, and vaccine candidates, have been registered worldwide. While remdesivir, the anti-Ebola virus drug, has been approved as an 'emergency use' drug in the USA, favipiravir, the anti-flu drug, has been recently approved in Russia. Tocilizumab and sarilumab, the cytokine (IL-6) antagonists, have entered Phase-II/III clinical trials in hospitalized COVID-19 patients. Among the leading vaccine candidates, Phase-III clinical trial results of Moderna, Pfizer and Oxford vaccines seem to be game changers for COVID19. Conclusion(s): The world health authorities have strongly and quickly responded to the COVID-19 pan-demic. Nonetheless, world bodies must unite in combating this health crisis by developing cost-effective drugs and vaccines and making them accessible to resource-poor countries.Copyright © 2021 Bentham Science Publishers.

A Brief Outlook on Possible Available Solutions, Therapies and Suggestions for COVID-19

Background: The WHO has declared COVID-19 as a global pandemic. New cases are being added every day, as the case count in the United States is increasing to the maximum. No drugs or biol-ogics are yet found to be effective for the prevention or treatment of COVID-19. Objective(s): To discuss the possibilities of available treatments. Material(s) and Method(s): Brief out-look is undertaken over the past issues available over similar situations that occurred with respect to the current scenario and prospectives. Result(s): There can be various possibilities in the form of convalescent plasma therapy. The known drugs such as HIV drugs, anti-malarial medicines, and antiviral compounds can serve as a suggestive option. Conclusion(s): Until a validated medicine or vaccine is sorted out for Covid-19, we need to take natural immune-boosters, along with precautionary steps, social distancing, and other preventions as instructed for the benefit of everyone with an optimistic mind and attitude.Copyright © 2021 Bentham Science Publishers.

Boosting Innate Immunity During SARS-CoV-2 Clearance

Currently, humanity is suffering from a highly contagious and infectious novel coron-avirus disease. Due to the unavailability of any specifically approved therapy to eradicate this pathogenic virus, day by day, it is claiming more and more lives of humans. Observing the current scenario, human civilization seems to be in dangerous situation, and the development of a potential vaccine against this invisible enemy may take some more time. It was observed that the individual immune system plays an important role in the fight against the novel coronavirus. Additionally, the innate immune system of the host acts as the first line of defense against invading pathogenic virus-es. The host innate immune cells can detect and detoxify the evading viruses. Thus, boosting the innate immune response via targeting activator or inhibitory immune check points pathways for en-hancing T-cell immune response may potentially help the patients to fight against this deadly virus. The aim of this editorial is to discuss in brief about the pathogenesis of COVID-19, the role of innate immunity and autophagy during viral clearance.Copyright © 2021 Bentham Science Publishers.

COVID-19 Pandemic: An Overview of its Origin, Current Status, and Ongoing Clinical Trials

The COVID-19 pandemic is raging across the globe, with the total active cases increas-ing each day. Globally over 63 million COVID-19cases and more than 1.4 million deaths have been reported to WHO. Throughout the world, academicians, clinicians and scientists are working tirelessly on developing a treatment to combat this pandemic. The origin of novel SARS-CoV-2 virus still remains foggy but is believed to have originated from a bat coronavirus RaTG13 with which it shares approximately 96% sequence similarity. In the present review, the authors have pro-vided an overview of the COVID-19 pandemic, epidemiology, transmission, developments related to diagnosis, drugs and vaccines, along with the genetic diversity and lifecycle of the SARS-CoV-2 based on the current studies and information available.Copyright © 2022 Bentham Science Publishers.

Clinical efficacy and safety of convalescent plasma therapy for patients with SARS-CoV-2 infection.

Aim: to evaluate the efficacy and safety of convalescent plasma therapy for patients with severe SARS-CoV-2 infection. Material(s) and Method(s): the study included 64 patients with laboratory-confirmed severe new coronavirus infection. The control group consisted of 58 patients who, in addition to standard therapy, received a transfusion of plasma from donors who had recovered from COVID-19. The effectiveness of immune plasma was assessed by the duration of fever, the level of oxygen (SpO2%) in dynamics, the detection of SARSCoV-2 RNA in nasopharyngeal and oropharyngeal swabs using PCR method in dynamics, as well as by the dynamics of blood tests results. Adverse events (any medically adverse events that occurred after immune plasma transfusion) were recorded as safety criteria. Result(s): patients who received convalescent plasma, showed a significantly shorter period of SARS-CoV-2 replication compared with the control group. The use of immune plasma did not have a statistically significant effect on the duration of the fever, as well as the dynamics of blood oxygenation. Also, there were no significant differences compared with the control group when assessing blood tests parameters. Conclusion(s): The use of COVID-19 convalescent plasma to treat severe COVID-19 did not show significant clinical effect but reduced the period of viral replication. It also showed no unexpected or serious adverse events.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Clinical efficacy and safety of convalescent plasma therapy for patients with SARS-CoV-2 infection.

Aim: to evaluate the efficacy and safety of convalescent plasma therapy for patients with severe SARS-CoV-2 infection. Material(s) and Method(s): the study included 64 patients with laboratory-confirmed severe new coronavirus infection. The control group consisted of 58 patients who, in addition to standard therapy, received a transfusion of plasma from donors who had recovered from COVID-19. The effectiveness of immune plasma was assessed by the duration of fever, the level of oxygen (SpO2%) in dynamics, the detection of SARSCoV-2 RNA in nasopharyngeal and oropharyngeal swabs using PCR method in dynamics, as well as by the dynamics of blood tests results. Adverse events (any medically adverse events that occurred after immune plasma transfusion) were recorded as safety criteria. Result(s): patients who received convalescent plasma, showed a significantly shorter period of SARS-CoV-2 replication compared with the control group. The use of immune plasma did not have a statistically significant effect on the duration of the fever, as well as the dynamics of blood oxygenation. Also, there were no significant differences compared with the control group when assessing blood tests parameters. Conclusion(s): The use of COVID-19 convalescent plasma to treat severe COVID-19 did not show significant clinical effect but reduced the period of viral replication. It also showed no unexpected or serious adverse events.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

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

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. Material(s) and Method(s): The English language databases of PubMed, Google Scholar, and Sci-enceDirect 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. Result(s): 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-transfu-sion. The improvement in clinical symptoms following CP therapy was demonstrated in 9 studies. Most of the patients experienced very few adverse effects. Conclusion(s): 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 prophy-lactic agent(s). The substantial randomized controlled trials (RCTs) are necessary to validate the effectiveness of such therapy.Copyright © 2021 Bentham Science Publishers.

Liver and COVID-19 - A Review and Clinical Approach

Liver enzyme abnormalities occur frequently in patients diagnosed with Coronavirus disease 2019 (COVID-19). It has been suggested that patients with severe acute liver injury are more likely to be admitted to intensive care, require intubation or renal replacement therapy and their mortality rate is higher than patients without severe acute liver injury. This review article explores the possible aetiologies of liver dysfunction seen in patients with COVID-19 and also the effect of COVID-19 on patients with pre-existing liver disease. Finally, we suggest clinical approaches to treating a patient with liver enzyme disturbance and COVID-19 and also caring for patients who require liver transplantation in the COVID-19 era.Copyright © 2022 Bentham Science Publishers.

World's Proposed Safeguard Against COVID-19 - A Brief Review

From December 2019 till now, the coronavirus disease pandemic has exposed the whole world to a new challenge where the survival of human beings faces an alarming phase. The humankind, with utmost intelligence, is trying to find out the key to unlock the lock made by SARSCoV-2, the causative virus of COVID-19. We here, briefly summarize the possible remedies so far introduced worldwide to combat the deadly pathogenic virus. The article includes the information of varieties of drugs applied globally: allopathic, homeopathic, Ayurveda, nanoparticle implicated protections and vaccination trials along with other biotechnical applications in different countries. Our review work may be useful to scientists involved in research in this field to know the global remedial aspects so far developed and also to create awareness among people regarding the present pandemic and preventive mechanisms.Copyright © 2021 Bentham Science Publishers.

Coronavirus Disease 2019 (COVID-19): Current Situation and Therapeutic Options

Coronavirus disease 2019 (COVID-19) is defined as an illness caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). COVID-19 was first reported in the Wuhan, China, in late December, 2019. The World Health Organization (WHO) declared COVID-19 a global emergency on March 11, 2020. COVID-19 was rapidly transmitted and caused infection in 21,294,845 people and 761,779 deaths in more than 213 countries worldwide till August 16, 2020. United States of America (USA), Brazil, India, Russia Federation, Peru, Mexico, Colombia, Spain, France, Italy, Germany, and United Kingdom (UK) stand top COVID-19 affected countries in the world. The high transmission rate of COVID-19 might be due to large viral incubation time (2-14 days) and some modifications in the spike glycoprotein. Currently, effective drugs or vaccines are not developed for the treatment of novel coronavirus. However, few antibiotics like hydroxychloroquine and remdesivir have been currently used for the treatment of COVID-19 infection. Several collaboratives are working together for developing an effective and safe vaccine against COVID-19 and few vaccines are under clinical trial. Scientists are also working on plasma therapy and monoclonal antibodies. Nowadays, plasma therapy is considered the most effective treatment against COVID-19 and some promising results have been achieved. This review focuses on several therapeutic options for COVID-19, such as anti-viral drugs, vaccines, plasma therapy, and monoclonal antibodies. This review also covers the current situations of COVID-19 in the world. This review is about COVID-19, which will be beneficial to researchers for the development of potential treatment against it.Copyright © 2021 Bentham Science Publishers.

Deciphering the Potential Therapeutic Intervention Points of 2019-nCoV: A Pharmacological Perspective

The emerging and re-emergence of viral outbreaks in the history of mankind has always pose severe global intimidation to public health and economy. The debilitating effects of 2019-nCoV (2019 novel coronavirus) outbreak has swiftly spread worldwide due to its highly contagious nature with severe risk of respiratory tract infections and higher mortality rate, necessitating the urgent need for the production of effective vaccine and potential therapeutic agents. The active evolution of SARS-CoV-2 strain in different population and environment strive immense challenge against anti-viral therapeutic development based on viral pathogenicity. The potential FDA drugs are evaluated based on their known safety and efficacy with exceptional pharmacokinetic profiles for the treatment of nCoV-2019. Existing knowledge related to MERS-CoV and SARS-CoV epidemic has provided a better understanding to explore purposeful therapeutics strategies against novel coronavirus disease (COVID-19). To limited extend, the ongoing promising and hopeful treatments includes convalescent plasma therapy, remdesivir, lopinavir/ritonavir, ACE inhibitors, TMPRSS2 inhibitors, hydroxychloroquine, interferon, ribavirin, tocilizumab, and corticosteroids however clinical efficacy of some of them need to be validated in randomized clinical trials (RCTs). The global struggle to make a protected and successful Coronavirus immunization is finally proving to be fruitful. Although challenges such as strain variation resistant, possible side effects, adequate supply of vaccines to all countries and limited availability of second dose still diverting the option of possible efficacious therapeutics strategies to work alongside with vaccine development with improved efficacy and safety profile. This review is focused on the potential advancement in therapeutic approaches with possible repurposing of the available drugs and explores the current status of available vaccines with hope that these strategies found to be cogent in controlling SARS-CoV-2 outbreak. © 2022, The Running Line. All rights reserved.

A Narrative Review of Emerging Therapeutics for COVID-19.

The novel severe acute respiratory syndrome coronavirus 2, the causal agent of coronavirus disease 2019 (COVID-19), quickly spread around the world, resulting in the most aggressive pandemic experienced in more than 100 years. Research on targeted therapies and vaccines has been initiated on an unprecedented scale and speed but will take months and even years to come to fruition. Meanwhile, the efficacy of emerging therapeutics for use in treating COVID-19 is feverishly being investigated to identify the best available treatment options for dealing with the current wave of disease. This review of publications with a "treatment" tag through June 29, 2020 in the National Library of Medicine's LitCovid literature hub, provides frontline clinicians with a pragmatic summary of the current state of the rapidly evolving evidence supporting emerging candidate therapeutics for COVID-19. Two main categories of pharmaceutical therapeutics are showing promise: those with antiviral activity directly addressing infection and those that counteract the inflammatory cytokine storm induced by severe disease. Preliminary results suggest that other approaches such as convalescent plasma therapy and lung radiation therapy may have some efficacy. The current clinical evidence for potential treatments is preliminary-often small retrospective series or early results of randomized trials-and the science is evolving rapidly. The long-term results from large, well-designed randomized controlled trials will provide definitive evidence for therapeutic effectiveness and are likely months away. The trial landscape for promising therapies is described.

SARS-CoV-2 Therapy: Old Drugs as New Interventions

An outburst of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become a grave threat to global health and the economy. As of May 13, 2020, a total of 42,81,838 cases have been confirmed, with over 2,92,376 deaths worldwide. In India, 75,048 cases have been reported to date with 2,440 deaths. Management of this new coronavirus (COVID19) has mainly focused on infection prevention, case detection, monitoring, and supportive care. As there is no vaccine or specific antiviral treatment for human SARS-CoV-2, therefore identifying the drug treatment options as soon as possible is critical for the response to the COVID19 outbreak. Pro-inflammatory cascade and cytokine storm play a key role in the pathogenesis of new coronavirus. A large number of therapeutic interventions such as antiviral, antimalarial, convalescent plasma therapy, BCG vaccine, mTOR inhibi-tors, Tissue Plasminogen Activator, Human monoclonal antibodies, Anti-parasitic agents, Immunoen-hancers, Nutritional interventions, JAK-STAT signaling inhibitors, ACE2 receptor modulators, and An-giotensin II receptor blockers have been either tried or suggested for effective treatment of patients with SARS-CoV-2 disease. Hence, we recommend that all the above potential interventions must be imple-mented in terms of their safety and efficacy through proper clinical experiments to control the emerging SARS-CoV-2 disease.Copyright © 2021 Bentham Science Publishers.

Comorbidities and Clinical Outcomes of Patients with COVID 19 in a Tertiary Care Center at Goa: A Prospective Observational Study

Background: It is believed that COVID-19, in those with comorbidities, has an increasingly rapid and severe progression, often resulting in mortality. This study explores various comorbid conditions, disease severity, and clinical outcomes in patients infected with COVID-19. Method(s): This is a prospective observational study. Clinical data of COVID-19 patients admitted at Goa Medical College between November 23, 2020, to December 23, 2020, are summarized and analyzed using Google forms, spreadsheets, and R programming language. Result(s): A total of 100 patient data was collected, including 5% mild, 61% moderate, and 34% severe cases. Fever (83%) was the most common symptom, followed by dry cough (83%), dyspnoea (79%), and fatigue (32%). The most common comorbidities identified were diabetes (66%), hypertension (57%), and cardiovascular and cerebrovascular conditions (27%). Clinical outcome in patients was pneumonia (84%), ARDS (40%), bronchiolitis (10%), and shock (3%). Conclusion(s): Our study estimated that older men with underlying hypertension, diabetes, cardiovascular, and cerebrovascular conditions are at higher risk for severe clinical form. Fever, cough, and dyspnea were the most common signs on admission. The laboratory parameters showed a significant increase in CRP, ferritin, LDH, procalcitonin, ESR, and d-dimer in the case of SARS-CoV-2 infection.Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.

Emergence of a New Zoonotic COVID-19 that Creates a Pandemic: Update on Current Pharmacotherapeutics and Future Prospective of Plasma Therapy

The current decade started on an unexpected note, with almost the entire world grappling with a newly arisen pandemic. A novel coronavirus, tracing its first human host to a Chinese province, has spread to all geographical areas with human populations. The virus, named SARS-CoV-2, infects the lower respiratory tract, much like other coronaviruses, that caused the 2002 epidemic, to which it is eponymous. The severity of infection is seen in individuals with comorbidities like diabetes, cardiovascular disorders, chronic respiratory problems, hypertension, cancer, etc. This virus represents another incidence of zoonosis to humans and has infected over eighteen million people since December 2019, of its first human transmission. All the currently employed therapies are either aimed at alleviating the severity of the symptoms or being administered on a trial basis. This review attempts to summarize brief aetiology of the virus, epidemiology of the outbreak, clinical symptoms of the disease with a postulated mechanism of pathogenesis and several existing and approved drugs and therapeutics along with plasma therapy, which are being clinically reviewed for their activity, as well as safety, against the disease;none of which are approved yet. A few promising vaccine candidates, as per in vivo studies, are also underway, but their evaluation might take a year at least. Meanwhile, experts have come up with the concept of "social distancing" to stem the viral spread, as the medical research fraternity of the world strives hard to find a safe, successful and effective cure for it.Copyright © 2021 Bentham Science Publishers.