The Role of Convalescent Plasma in COVID-19: A Conclusive Post-Pandemic Review
Abstract
:1. Introduction
2. Search Methods
3. Convalescent Plasma against COVID-19
3.1. Collection, Validation and Characteristics of CCP
3.2. Safety of CCP
3.3. Efficacy of CCP in Outpatients
3.4. Efficacy of CCP in Hospitalized Patients
3.5. Efficacy of CCP in Immunocompromised Patients
3.6. Greys Zones
3.7. Considerations for Next Pandemic
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
- Focosi, D.; Franchini, M.; Pirofski, L.A.; Burnouf, T.; Paneth, N.; Joyner, M.J.; Casadevall, A. COVID-19 Convalescent Plasma and Clinical Trials: Understanding Conflicting Outcomes. Clin. Microbiol. Rev. 2022, 35, e0020021. [Google Scholar] [CrossRef] [PubMed]
- Casadevall, A.; Joyner, M.J.; Pirofski, L.A.; Senefeld, J.W.; Shoham, S.; Sullivan, D.; Paneth, N.; Focosi, D. Convalescent plasma therapy in COVID-19: Unravelling the data using the principles of antibody therapy. Expert Rev. Respir. Med. 2023, 17, 381–395. [Google Scholar] [CrossRef] [PubMed]
- Bihariesingh-Sanchit, R.; Bansie, R.; Ramdhani, N.; Mangroo, R.; Bustamente, D.; Diaz, E.; Fung, A.F.C.; Thakoer, I.; Vreden, S.; Choudhry, Z.; et al. Reduced Mortality among COVID-19 ICU Patients after Treatment with HemoClear Convalescent Plasma in Suriname. mBio 2023, 14, e0337922. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Mazzetti, P.; Pistello, M.; Maggi, F. Viral infection neutralization tests: A focus on SARS-CoV-2 with implications for convalescent plasma therapy. Rev. Med. Virol. 2020, 31, e2170. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Casadevall, A. Pathogen reduction technologies need to evaluate Fc-mediated antibody functions. Transfusion, 2022; in press. [Google Scholar]
- Focosi, D.; Franchini, M. Impact of pathogen-reduction technologies on COVID-19 convalescent plasma potency. Transfus. Clin. Biol. J. Soc. Fr. Transfus. Sang. 2021, 28, 132–134. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Franchini, M. Clinical predictors of SARS-CoV-2 neutralizing antibody titers in COVID-19 convalescents: Implications for convalescent plasma donor recruitment. Eur. J. Haematol. 2021, 107, 24–28. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Meschi, S.; Coen, S.; Iorio, M.C.; Franchini, M.; Lanza, M.; Maggi, F. Serum anti-Spike immunoglobulin G levels in random blood donors in Italy: High-titre convalescent plasma is easier than ever to procure. Vox Sang. 2023, 118, 794–797. [Google Scholar] [CrossRef] [PubMed]
- McGregor, R.; Carlton, L.; Paterson, A.; Hills, T.; Charlewood, R.; Moreland, N.J. Neutralization capacity of convalescent plasma against SARS-CoV-2 omicron sublineages: Implications for donor selection. Vox Sang. 2023. [Google Scholar] [CrossRef]
- Focosi, D.; Farrugia, A. Urgent need to regulate convalescent plasma differently from thawed plasma. Transf. Med. Hemother. 2020, 48, 132–133. [Google Scholar] [CrossRef]
- Focosi, D.; Moscato, G.; Pistello, M.; Maggi, F. Kinetics of anti-SARS-COV-2 spike protein IgG and IgA antibodies at 4 °C: Implications for convalescent plasma stability. Transfus. Med. 2021, 31, 221–222. [Google Scholar] [CrossRef]
- Focosi, D.; Franchini, M.; Pirofski, L.-a.; Burnouf, T.; Fairweather, D.; Joyner, M.J.; Casadevall, A. COVID-19 Convalescent Plasma Is More than Neutralizing Antibodies: A Narrative Review of Potential Beneficial and Detrimental Co-Factors. Viruses 2021, 13, 1594. [Google Scholar] [CrossRef]
- Franchini, M.; Focosi, D.; Corsini, F.; Cruciani, M. Safety and efficacy of convalescent plasma in COVID-19: An overview of systematic reviews. Diagnostics 2021, 11, 1663. [Google Scholar] [CrossRef]
- Huaman, M.A.; Raval, J.S.; Paxton, J.H.; Mosnaim, G.S.; Patel, B.; Anjan, S.; Meisenberg, B.R.; Levine, A.C.; Marshall, C.E.; Yarava, A.; et al. Transfusion reactions associated with COVID-19 convalescent plasma in outpatient clinical trials. Transfusion 2023, 63, 1639–1648. [Google Scholar] [CrossRef] [PubMed]
- Franchini, M.; Cruciani, M.; Casadevall, A.; Joyner, M.J.; Senefeld, J.; Sullivan, D.; Zani, M.; Focosi, D. Safety of COVID-19 convalescent plasma: A definitive systematic review and meta-analysis of randomized controlled trials. Transfusion, 2023; in press. [Google Scholar]
- Sullivan, D.J.; Focosi, D.; Hanley, D.F.; Cruciani, M.; Franchini, M.; Ou, J.; Casadevall, A.; Paneth, N. Outpatient regimens to reduce COVID-19 hospitalisations: A systematic review and meta-analysis of randomized controlled trials. medRxiv 2023. [Google Scholar] [CrossRef]
- Focosi, D.; Quiroga, R.; McConnell, S.; Johnson, M.C.; Casadevall, A. Convergent evolution in SARS-CoV-2 Spike creates a variant soup from which new COVID-19 waves emerge. Int. J. Mol. Sci. 2023, 24, 2264. [Google Scholar] [CrossRef]
- Focosi, D.; McConnell, S.; Sullivan, D.J.; Casadevall, A. Analysis of SARS-CoV-2 mutations associated with resistance to therapeutic monoclonal antibodies that emerge after treatment. Drug Resist. Updates 2023, 71, 100991. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; McConnell, S.; Shoham, S.; Casadevall, A.; Maggi, F.; Antonellli, G. Nirmatrelvir and COVID-19: Development, pharmacokinetics, clinical efficacy, resistance, relapses, and pharmacoeconomics. Int. J. Antimicrob. Agents 2023, 61, 106708. [Google Scholar] [CrossRef] [PubMed]
- Sullivan, D.; Gebo, K.; Shoham, S.; Bloch, E.; Lau, B.; Shenoy, A.; Mosnaim, G.; Gniadek, T.; Fukuta, Y.; Patel, B.; et al. Early Outpatient Treatment for COVID-19 with Convalescent Plasma. N. Engl. J. Med. 2021, 386, 1700–1711. [Google Scholar] [CrossRef] [PubMed]
- Senefeld, J.W.; Gorman, E.K.; Johnson, P.W.; Moir, M.E.; Klassen, S.A.; Carter, R.E.; Paneth, N.S.; Sullivan, D.J.; Morkeberg, O.H.; Wright, R.S.; et al. Rates among Hospitalized Patients with COVID-19 Treated with Convalescent Plasma: A Systematic Review and Meta-Analysis. Mayo Clin. Proc. Innov. Qual. Outcomes 2023, 7, 499–513. [Google Scholar] [CrossRef] [PubMed]
- Menichetti, F.; Popoli, P.; Puopolo, M.; Spila Alegiani, S.; Tiseo, G.; Bartoloni, A.; De Socio, G.; Luchi, S.; Blanc, P.; Puoti, M.; et al. Effect of High-Titer Convalescent Plasma on Progression to Severe Respiratory Failure or Death in Hospitalized Patients with COVID-19 Pneumonia: A Randomized Clinical Trial. Submitted 2021, 4, e2136246. [Google Scholar] [CrossRef]
- Focosi, D. Molnupiravir: From Hope to Epic Fail? Viruses 2022, 14, 2560. [Google Scholar] [CrossRef]
- Hoertel, N.; Boulware, D.R.; Sánchez-Rico, M.; Burgun, A.; Limosin, F. Prevalence of Contraindications to Nirmatrelvir-Ritonavir among Hospitalized Patients with COVID-19 at Risk for Progression to Severe Disease. JAMA Netw. Open 2022, 5, e2242140. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Franchini, M. COVID-19 neutralizing antibody-based therapies in humoral immune deficiencies: A narrative review. Transfus. Apher. Sci. 2021, 60, 103071. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Franchini, M. Potential use of convalescent plasma for SARS-CoV-2 prophylaxis and treatment in immunocompromised and vulnerable populations. Expert Rev. Vaccines 2021, 21, 877–884. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Senefeld, J.W.; Joyner, M.J.; Sullivan, D.; Casadevall, A.; Bloch, E.M.; Franchini, M. Lower anti-spike levels in B-cell-depleted patients after convalescent plasma transfusion suggest the need for repeated doses. Br. J. Haematol. 2022, 200, E22–E24. [Google Scholar] [CrossRef]
- Denkinger, C.M.; Janssen, M.; Schäkel, U.; Gall, J.; Leo, A.; Stelmach, P.; Weber, S.F.; Krisam, J.; Baumann, L.; Stermann, J.; et al. Anti-SARS-CoV-2 antibody-containing plasma improves outcome in patients with hematologic or solid cancer and severe COVID-19: A randomized clinical trial. Nat. Cancer 2023, 4, 96–107. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Franchini, M.; Senefeld, J.; Casadevall, A.; Joyner, M. Convalescent plasma for COVID-19 in oncohematological patients: A call for revision of the European Conference on Infections in Leukemia-9 guidelines. JCV Plus 2022, 3, 100128. [Google Scholar] [CrossRef] [PubMed]
- Franchini, M.; Casadevall, A.; Senefeld, J.; Joyner, M.; Sullivan, D.; Focosi, D. Recommendations on the use of COVID-19 convalescent plasma in immunocompromised patients. Semin. Thromb. Hemost. 2023. [Google Scholar] [CrossRef]
- Franchini, M.; Casadevall, A.; Joyner, M.J.; Focosi, D. WHO Is Recommending against the Use of COVID-19 Convalescent Plasma in Immunocompromised Patients? Life 2023, 13, 134. [Google Scholar] [CrossRef]
- Iannizzi, C.; Chai, K.L.; Piechotta, V.; Valk, S.J.; Kimber, C.; Monsef, I.; Wood, E.M.; Lamikanra, A.A.; Roberts, D.J.; McQuilten, Z.; et al. Convalescent plasma for people with COVID-19: A living systematic review. Cochrane Database Syst. Rev. 2023, 5, Cd013600. [Google Scholar] [CrossRef]
- Focosi, D.; Maggi, F.; Franchini, M.; Aguzzi, A.; Lanza, M.; Mazzoni, A.; Menichetti, F. Patient-blood management for COVID19 convalescent plasma therapy: Relevance of affinity and donor-recipient differences in concentration of neutralizing antibodies. Clin. Microbiol. Infect. 2021, 27, 987–992. [Google Scholar] [CrossRef] [PubMed]
- Franchini, M.; Maggi, F.; Focosi, D. ABO blood group-related mechanism of infection of SARS-CoV-2: An overview of systematic reviews. Clin. Chem. Lab. Med. 2023. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Iorio, M.C.; Lanza, M. ABO Blood Group Correlations with COVID-19: Cohort Choice Makes a Difference. Clin. Infect. Dis. 2020, 72, e919. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Maggi, F.; D’Abramo, A.; Nicastri, E.; Sullivan, D.J. Antiviral combination therapies for persistent COVID-19 in immunocompromised patients. Int. J. Infect. Dis. 2023, 137, 55–59. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Maggi, F. Respiratory delivery of passive immunotherapies for SARS-CoV-2 prophylaxis and therapy. Hum. Vaccines Immunother. 2023, 19, 2260040. [Google Scholar] [CrossRef] [PubMed]
- Bloch, E.M.; Focosi, D.; Shoham, S.; Senefeld, J.; Tobian, A.A.R.; Baden, L.R.; Tiberghien, P.; Sullivan, D.; Cohn, C.; Dioverti, V.; et al. Guidance on the use of convalescent plasma to treat immunocompromised patients with COVID-19. Clin. Infect. Dis. 2023, 76, 2018–2024. [Google Scholar] [CrossRef] [PubMed]
- Agarwal, A.; Mukherjee, A.; Kumar, G.; Chatterjee, P.; Bhatnagar, T.; Malhotra, P.; Latha, B.; Bundas, S.; Kumar, V.; Dosi, R.; et al. Convalescent plasma in the management of moderate COVID-19 in India: Open-label parallel-arm phase II multicentre randomized controlled trial (PLACID Trial). BMJ 2020, 371, m3939. [Google Scholar] [CrossRef] [PubMed]
- Focosi, D.; Franchini, M. Data Sharing Statements: The Case of the TSUNAMI Trial in Italy. J. Environ. Sci. Public Health 2023, 7. in press. [Google Scholar]
- Focosi, D.; Franchini, M. Passive immunotherapies for COVID-19: The subtle line between standard and hyperimmune immunoglobulins is getting invisible. Rev. Med. Virol. 2022, 32, e2341. [Google Scholar] [CrossRef]
- Focosi, D.; Franchini, M.; Tuccori, M. The road towards polyclonal anti-SARS-CoV-2 immunoglobulins (hyperimmune serum) for passive immunization in COVID-19. Life 2021, 11, 144. [Google Scholar] [CrossRef]
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Franchini, M.; Focosi, D. The Role of Convalescent Plasma in COVID-19: A Conclusive Post-Pandemic Review. Life 2023, 13, 2322. https://doi.org/10.3390/life13122322
Franchini M, Focosi D. The Role of Convalescent Plasma in COVID-19: A Conclusive Post-Pandemic Review. Life. 2023; 13(12):2322. https://doi.org/10.3390/life13122322
Chicago/Turabian StyleFranchini, Massimo, and Daniele Focosi. 2023. "The Role of Convalescent Plasma in COVID-19: A Conclusive Post-Pandemic Review" Life 13, no. 12: 2322. https://doi.org/10.3390/life13122322