Indications and contraindications for convalescent plasma therapy in COVID-19 — a mini-review
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Abstract
Introduction: Convalescent plasma (CP), containing neutralizing antibodies (NAbs), is considered to be potential COVID-19 therapy. Favorable effects of passive administration of NAbs were already demonstrated for other viruses, including SARS and MERS viruses belonging to the Coronaviridae family.
Aim of the study: This review aims to present and systematize current indications and contraindications for COVID-19 CP therapy.
Material and methods: A systematic review of the literature was conducted using Pubmed, Wiley Online Library, Science Direct, and Medline databases.
Results: At present, there is no strong evidence from randomized clinical trials to create universal eligibility criteria for CP treatment. Based on conducted studies and expert opinions, it is considered reasonable to administer CP to patients with a severe course of infection or with a risk of such a course, in the early stages of infection, optimally during 72h from symptom onset. Regarding contraindications to CP therapy, to a large extent, they are the same as commonly known and accepted contraindications for transfusion of routinely obtained plasma. Additionally, CP donations are subjected to obligatory pathogen reduction (PR). The exposure to photosensitizing substances, remaining in the CP following PR, might be associated with adverse effects.
Conclusions: CP transfusion should not be a stand-alone treatment but should be used in clinical trials as a complement to other available COVID-19 therapies if possible. Patients should be informed that the effectiveness of CP has not been sufficiently proven, and that therapy is dependent on the physician’s decision and the availability of CP.
Keywords: convalescent plasmaCOVID-19pathogen reductionIgGSARS-CoV-2
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