Convalescent plasma therapy: a passive therapy for an aggressive COVID-19. (Special issue on new coronavirus (2019-nCoV or SARS-CoV-2) and the outbreak of the respiratory illness (COVID-19): part-VII.)

ABSTRACT

The basic concept for use of convalescent plasma in COVID-19 is as a delivery system for viral neutralizing antibodies, that is to confer passive immunity. Given the fact that they do not have reliable targeted drugs or a vaccine yet, the option of convalescent plasma seems reasonable to boost the immune system of infected patients or susceptible population immediately. This is not a new concept, rather this has been utilized for over 100 years, even predating the discovery of antibiotics. Once it is confirmed that the proposed donor is no longer contagious, the next step would be to see if the donor has adequate levels of antibodies to donate. This can be done by measuring SARS-CoV-2 antibody levels to ensure adequate titers in the donor's circulation. The FDA recommends a SARS-CoV-2 neutralising antibody titer of at least 1160 as an inclusion criterion for donor selection. If a compatible unit is not available, the FDA suggests that a titer of 180 may be considered acceptable. While waiting for an effective vaccine and / or antiviral agent against COVID-19, experimental therapies are currently being tested in clinical trials. So far, plasma therapy has provided encouraging results with no serious events. It is expected that an increasing use of convalescent plasma for the treatment of seriously ill patients and possibly earlier in the course of the disease and/or for prophylaxis in the coming months. The American Red Cross, the United States government, researchers at the Mayo Clinic, and many others across the country are now working hard to identify suitable donors and establish tests to confirm neutralizing antibodies in such a way that they timely. Since the antibody test is validated, it should help support the most effective use of convalescent plasma. Additionally, efforts are being made to continue the production of a COVID-19 immunoglobulin that could provide a more reliable, effective, and more available plasma-based therapy for this formidable virus.