scholarly journals Effectiveness and controversy of convalescent plasma therapy for COVID-19 patients

2020 ◽  
Author(s):  
zhanjun Shu ◽  
xin Da ◽  
qianqian Qian ◽  
dandan Du ◽  
ke Wang
Keyword(s):  
Clinical Symptoms ◽  
Standard Procedure ◽  
Neutralizing Antibody ◽  
Therapeutic Agents ◽  
Adverse Outcomes ◽  
Plasma Therapy ◽  
Randomized Controlled ◽  
New Treatments ◽  
Plasma Collection ◽  
Dosage Frequency

Coronavirus disease2019(COVID-19) is a pandemic with no specific therapeutic agents and substantial mortality. It is critical to find new treatments. Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. Therefore, for COVID-19 patients, Convalescent plasma, could prove lifesaving, such as improving the clinical symptoms, increasing the neutralizing antibody, decreasing the viral load , reducing the death rate, with safety and without seriously ADE. Meanwhile, it is urgent to perform large sample randomized controlled trials to confirm the transfusion timing, dosage, frequency and actively prevent adverse outcomes that may occur, establishing a standard procedure for treatment from convalescent plasma collection, preservation, transport, to transfusion.

scholarly journals The feasibility of convalescent plasma therapy in severe COVID- 19 patients: a pilot study

2020 ◽  
Author(s):  
Kai Duan ◽  
Bende Liu ◽  
Cesheng Li ◽  
Huajun Zhang ◽  
Ting Yu ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Clinical Symptoms ◽  
Antiviral Agents ◽  
Neutralizing Antibody ◽  
Optimal Dose ◽  
Plasma Therapy ◽  
Reactive Protein ◽  
Antibody Titers ◽  
Novel Coronavirus ◽  
High Level

AbstractCurrently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65×109/L vs. 0.76×109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.

scholarly journals The efficacy assessment of convalescent plasma therapy for COVID-19 patients: a multi-center case series

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Hao Zeng ◽  
Dongfang Wang ◽  
Jingmin Nie ◽  
Haoyu Liang ◽  
Jiang Gu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Case Series ◽  
Neutralizing Antibody ◽  
Plasma Therapy ◽  
Laboratory Parameters ◽  
Wide Range ◽  
Efficacy Assessment ◽  
Radiological Image

Abstract Convalescent plasma (CP) transfusion has been indicated as a promising therapy in the treatment for other emerging viral infections. However, the quality control of CP and individual variation in patients in different studies make it rather difficult to evaluate the efficacy and risk of CP therapy for coronavirus disease 2019 (COVID-19). We aimed to explore the potential efficacy of CP therapy, and to assess the possible factors associated with its efficacy. We enrolled eight critical or severe COVID-19 patients from four centers. Each patient was transfused with 200–400 mL of CP from seven recovered donors. The primary indicators for clinical efficacy assessment were the changes of clinical symptoms, laboratory parameters, and radiological image after CP transfusion. CP donors had a wide range of antibody levels measured by serology tests which were to some degree correlated with the neutralizing antibody (NAb) level. No adverse events were observed during and after CP transfusion. Following CP transfusion, six out of eight patients showed improved oxygen support status; chest CT indicated varying degrees of absorption of pulmonary lesions in six patients within 8 days; the viral load was decreased to a negative level in five patients who had the previous viremia; other laboratory parameters also tended to improve, including increased lymphocyte counts, decreased C-reactive protein, procalcitonin, and indicators for liver function. The clinical efficacy might be associated with CP transfusion time, transfused dose, and the NAb levels of CP. This study indicated that CP might be a potential therapy for severe patients with COVID-19.

scholarly journals INVESTIGATIVE THERAPY OF COVID-19 CASES WITH CONVALESCENT PLASMA

2021 ◽  
pp. 1-3
Author(s):  
Anjan Jyoti Talukdar ◽  
Raj Pratim Das ◽  
Basanta Hazarika ◽  
Priyam Saikia ◽  
Tirtha Chaliha ◽  
...  
Keyword(s):  
Observational Study ◽  
Neutralizing Antibody ◽  
Supplemental Oxygen ◽  
Therapeutic Agents ◽  
Rt Pcr ◽  
Plasma Therapy ◽  
Clinical Benefits ◽  
Antibody Titers ◽  
Novel Coronavirus ◽  
Pcr Test

BACKGROUD:Covid-19hasemergedhasanalarmingpublichealthcrisis,puttingthehealthcarefacilitiesacross theglobeat strain.Even after almost ten months of its identification,there exists only a few specific approved therapeutic agents for novel coronavirus disease.In this observational study,we have looked for any clinical benefits of convalescent plasma therapy in moderately severe cases of Covid-19,when added to a regimen consisting of Remdesivir,Dexamethasone and Heparin. METHODOLOGY: 528 moderately severe patients confirmed by RT-PCR test were enrolled. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to 268 patients as an addition to maximal supportive care and Remdesivir with steroid and heparin while 260 receivedRemdesivir with steroid and heparin. RESULTS:Theprimaryendpointwasmortalitybenefit.Thesecondendpointswerethereductionindaysofhospitalization,viral clearanceandimprovementofclinical symptoms.Themediantimefromonsetofillness toplasmatransfusionwas9.55d(range 6-24d).Nosevereadverseeffectswereobserved. CONCLUSION:Our studyshowedthatCPTcouldimprovesurvivalinpatientswhenaddedtothestandardtherapyinpatients with moderate Covid-19 infection. The add on therapy also significantly reduced the need for supplemental oxygen in the survivorsItcouldpotentiallyimprovetheclinicaloutcomesbesidesbeingawell-toleratedmodalityoftreatment.

scholarly journals Effectiveness of convalescent plasma therapy in severe COVID-19 patients

2020 ◽  
Vol 117 (17) ◽  
pp. 9490-9496 ◽  
Author(s):  
Kai Duan ◽  
Bende Liu ◽  
Cesheng Li ◽  
Huajun Zhang ◽  
Ting Yu ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Antiviral Agents ◽  
Neutralizing Antibody ◽  
Optimal Dose ◽  
Plasma Therapy ◽  
Oxyhemoglobin Saturation ◽  
Reactive Protein ◽  
Antibody Titers ◽  
Novel Coronavirus ◽  
High Level

Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 109/L vs. 0.76 × 109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.

scholarly journals LESSONS AND NEW PERSPECTIVES: IS CONVALESCENT PLASMA THERAPY EFFECTIVE ON COVID-19 PATIENTS?

2022 ◽  
pp. 50-57
Author(s):  
HERNITA TAURUSTYA ◽  
SRI YUNITA ◽  
YSRAFIL YSRAFIL ◽  
NUKE PRATIWI ◽  
ANINDITA RAHMATIAH
Keyword(s):  
Length Of Stay ◽  
Neutralizing Antibodies ◽  
Clinical Symptoms ◽  
Neutralizing Antibody ◽  
Cochrane Collaboration ◽  
Disease Course ◽  
Journal Articles ◽  
Plasma Therapy ◽  
Contagious Diseases ◽  
Reduction Of Mortality

Objective: Recently, convalescent plasma (CP) therapy has shown promising evidence in the treatment of several serious contagious diseases, including SARS-CoV, Influenza and Ebola. We conducted a systematic review to extract data about using CP treatment for COVID-19 patients and it’s effectively. Methods: The retrieval of studies was conducted according to Cochrane Collaboration and from electronic databases including PubMed, Medline, and others (medRxiv and BioRxiv). Searching of the available evidence concerning CP treatment of COVID-19 patients was conducted in journal articles published between December 2019 and October 2020. The articles were further screened based on inclusion and exclusion criteria to identify the high-quality studies for analysis. Results: A total of 18 CP studies were included in this review. We found variance regarding the effectiveness of CP in the reduction of mortality rate, length of stay, and increased discharging rate. Several findings show CP therapy is effective in increasing viral negativity, neutralizing antibodies to recipients, does not cause harmful adverse reactions and in some cases can improve clinical symptoms. This therapy is presently considered effective for generating good clinical outcomes when given early in the course of the disease. Conclusion: The effectiveness of CP in terms of mortality, length of stay, and increased discharging patients is still debatable. However, CP therapy is effective in increasing the negativity of SARS-CoV-2 test, neutralizing antibody titer and is safe so it can be considered for COVID-19 patients. CP should not be given in the initial disease course but is recommended for the early disease course.

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

scholarly journals Chrysin Inhibits TNFα-Induced TSLP Expression through Downregulation of EGR1 Expression in Keratinocytes

2021 ◽  
Vol 22 (9) ◽  
pp. 4350
Author(s):  
Hyunjin Yeo ◽  
Younghan Lee ◽  
Sungshin Ahn ◽  
Euitaek Jung ◽  
Yoongho Lim ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Skin Lesions ◽  
Therapeutic Agents ◽  
Mitogen Activated Protein Kinase ◽  
Necrosis Factor Alpha ◽  
Extracellular Signal ◽  
Mitogen Activated Protein ◽  
Signaling Axis ◽  
Factor Alpha ◽  
Necrosis Factor

Thymic stromal lymphopoietin (TSLP) is an epithelial cell-derived cytokine that acts as a critical mediator in the pathogenesis of atopic dermatitis (AD). Various therapeutic agents that prevent TSLP function can efficiently relieve the clinical symptoms of AD. However, the downregulation of TSLP expression by therapeutic agents remains poorly understood. In this study, we investigated the mode of action of chrysin in TSLP suppression in an AD-like inflammatory environment. We observed that the transcription factor early growth response (EGR1) contributed to the tumor necrosis factor alpha (TNFα)-induced transcription of TSLP. Chrysin attenuated TNFα-induced TSLP expression by downregulating EGR1 expression in HaCaT keratinocytes. We also showed that the oral administration of chrysin improved AD-like skin lesions in the ear and neck of BALB/c mice challenged with 2,4-dinitrochlorobenzene. We also showed that chrysin suppressed the expression of EGR1 and TSLP by inhibiting the extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) 1/2 mitogen-activated protein kinase pathways. Collectively, the findings of this study suggest that chrysin improves AD-like skin lesions, at least in part, through the downregulation of the ERK1/2 or JNK1/2-EGR1-TSLP signaling axis in keratinocytes.

Nonpharmacological Techniques to Reduce Pain in Preterm Infants Who Receive Heel-Lance Procedure: A Randomized Controlled Trial

2014 ◽  
Vol 28 (4) ◽  
pp. 335-348 ◽  
Author(s):  
Piera Bergomi ◽  
Michele Chieppi ◽  
Antonella Maini ◽  
Tiziana Mugnos ◽  
Debora Spotti ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Wolfgang Amadeus Mozart ◽  
Controlled Trial ◽  
Standard Procedure ◽  
Blood Collection ◽  
Randomized Controlled ◽  
Heel Lance

Introduction: The heel-lance (HL) method for blood collection from the newborn is controversial for the pain it causes. This is the first randomized controlled trial on the management and reduction of pain using the music of Wolfgang Amadeus Mozart (“Sonata K. 448”) in premature infants hospitalized in a neonatal intensive care unit (NICU). This study has compared nonpharmacological techniques with standard procedure for reducing pain during HL procedure. Methods: Thirty-five premature infants were enrolled, each for 3 HL procedures, of which each was randomized to 1 of the 3 study arms. Arms were then compared in terms of the Premature Infant Pain Profile (PIPP) changes by analysis of variance (ANOVA). Results: One hundred five HL procedures were available for analysis (35 standard procedure, 35 music, 35 glucose). Median baseline PIPP was 3, and median PIPP after the HL procedure was 5. PIPP scale change was +3 in the control arm, +1 in the glucose arm, +2 in the music arm (p = .008). Discussion: Both glucose and music were safe and effective in limiting pain increase when compared to standard procedure in HL procedures in preterm infants.

scholarly journals Convalescent Plasma Therapy in COVID 19 an Indian Scenario: Comprehensive Review

2021 ◽  
pp. 453-465
Author(s):  
Shruti Vimal ◽  
Pratiksha Naval ◽  
Manoj Sawadker ◽  
Pallavi Bhomia ◽  
Neha Jadhav ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Neutralizing Antibodies ◽  
Clinical Symptoms ◽  
Scientific Data ◽  
Plasma Transfusion ◽  
Eligibility Criteria ◽  
Plasma Therapy ◽  
Comprehensive Review ◽  
Proof Of Efficacy ◽  
Indian Scenario

The recent pandemic due to Corona virus more popularly known as COVID 19 has reassessed the usefulness of historic convalescent plasma transfusion. (CPT) The CPT is one of the promising therapies in the current pandemic situation. This review was conducted to evaluate the effectiveness of CPT therapy in COVID 19 patients based on the publications reported till date. PubMed, EMBASE and Medline databases were screened up to 30 April 2021. All the records were screened as per the protocol eligibility criteria.  The main features of the studies reviewed were, convalescent plasma can reduce mortality in severely ill patients, an increase in neutralizing antibodies titre and disappearance of SARS CoV 2 RNA was observed in all the patients on CPT therapy and over all a beneficial effect on clinical symptoms after administration of CP.  Based on the review findings and the limited scientific data, CPT therapy in COVID 19 patients appear safe, clinically effective and reduces mortality. However, the need of a multicentre clinical trials, unequivocal proof of efficacy, effectiveness and the need for the standardisation of the CPT needs to be addressed immediately for the full utilisation of potential of CPT.

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