Coronavirus disease 2019 (COVID-19): Convalescent plasma & hyperimmune globulin
Coronavirus disease 2019 (COVID-19):
Convalescent plasma & hyperimmune globulin
Definition: Convalescent ptn plasma can be extracted from subjects who have already recovered
from COVID-19 infection and have developed
appropriate immune response. More than 100,000 units have been provided to ptns diagnosed with coronavirus disease 2019 (COVID-19)
through an extended access programs, emergent use authorization, and clinical studies.
Criteria for donation: Subjects can provide convalescent plasma
if they have the criteria for donation and already with full recovery from COVID-19 infection for at least 2 wks. The related information about donation
details have been provided via the US Food & Drug Administration (FDA), local
blood centers, and the concerned local institution. Methodology for plasma
recruitment may vary according to local policies.
Plasma collection: Plasma can be collected via PE (plasma apheresis). The level of the relevant AB can be recognized either on the donating subject or on the plasma unit using
a functional
or through serologic assessment.
Donors of the plasma should undergo the
necessary infectious disease screening in addition to the ABO & RhD
typing. The anti-human leukocyte antigen (HLA) AB
(donor excluded if +ve) is used in parous
female donors to decrease the
risk of transfusion-related acute lung injury (TRALI).
Indication for use: The
routine administration of convalescent plasma outside a clinical trial is not currently advised, as its benefit still uncertain. However, it’s available via
an emergency authorization, and other
physicians may prefer to utilize it. If so, the potential
benefit of convalescent plasma
seems to be most beneficial if administered early in the course
of severe illness.
Optimal administration: Convalescent plasma is most likely to be
effective if administered early in the course of the disease and if the reported titer
is minimally 1:160, despite the
need for additional studies to recognize the optimum
timing & titer. However, a
single dose of 1-2
units is typically administrated with no pre-medication, and the ptn
should be monitored clinically.
How to obtain the plasma: Contact information for obtaining plasma or
participating in clinical trials and special considerations for
resource-limited settings are summarized above.
Safety: Convalescent plasma administration may be complicated by the risk of transfusion reaction, as it occurs with
standard plasma. AB-dependent enhancement (ADE)
has not been observed but theoretically considered a possible risk. AB-containing products
may interfere with the efficacy
of vaccination , but this
assumption should be clinically assessed.
Hyperimmune globulin (HG): HG is a concentrated product manufactured from
thousands of units of convalescent plasma that’s also being pursued. The appropriate evidence
of efficacy still lacking.
REFERENCES
1.
https://www.uscovidplasma.org/
(Accessed on November 03, 2020).
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