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Convalescent blood plasma is a useful and relatively safe therapy for COVID-19, and perhaps should be used more widely, according to Prof Arturo Casadevall, Chair of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health.
Speaking during the 2020 ESCMID Conference on Coronavirus Disease (ECCVID), he said blood plasma is currently the only therapy against COVID-19 associated with a major reduction in mortality if given before ICU admission.
He quoted clinical trial data showing that convalescent blood plasma functions as an antiviral by reducing inflammation; a key issue in patients hospitalised with severe COVID-19.
Antibody levels are crucial to successful blood plasma treatment as they can vary per plasma unit so have results to date. When examining trial data, Prof Casadeval said that a number of antibody variables have to be considered — does the plasma have the specific antibodies to the SARS-CoV-2 antigen; are there sufficient antibody levels in the plasma; and was it given early enough to have an impact?
Prof Casadeval is involved in two major randomised, placebo-controlled clinical trials on convalescent blood plasma for COVID-19 treatment and prophylaxis, which he said should provide more definitive answers.
He noted that blood plasma has not gained the attention that some novel pharmaceutical COVID-19 treatments have. However many of these new treatments have limited efficacy and are very expensive, while convalescent blood plasma is cheap, low tech and easily deployable, and “it is remarkably well tolerated”, even in older sicker patients.
The current challenges are figuring out if, when and how to use it effectively.
Question: Which COVID-19 patients should receive convalescent blood plasma?
Casadeval: “It depends on the patient and plasma availability, but if you have high-quality plasma, and people in hospital, all the currently available evidence is that it is reasonably safe with good outcomes.”