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Lewin A, McGowan E, Ou-Yang J, Boateng LA, Dinardo CL, Mandal S, Almozain N, Ribeiro J, Sasongko SL. The future of blood services amid a tight balance between the supply and demand of blood products: Perspectives from the ISBT Young Professional Council. Vox Sang 2024; 119:505-513. [PMID: 38272856 DOI: 10.1111/vox.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/07/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND AND OBJECTIVES Blood services manage the increasingly tight balance between the supply and demand of blood products, and their role in health research is expanding. This review explores the themes that may define the future of blood banking. MATERIALS AND METHODS We reviewed the PubMed database for articles on emerging/new blood-derived products and the utilization of blood donors in health research. RESULTS In high-income countries (HICs), blood services may consider offering these products: whole blood, cold-stored platelets, synthetic blood components, convalescent plasma, lyophilized plasma and cryopreserved/lyophilized platelets. Many low- and middle-income countries (LMICs) aim to establish a pool of volunteer, non-remunerated blood donors and wean themselves off family replacement donors; and many HICs are relaxing the deferral criteria targeting racial and sexual minorities. Blood services in HICs could achieve plasma self-sufficiency by building plasma-dedicated centres, in collaboration with the private sector. Lastly, blood services should expand their involvement in health research by establishing donor cohorts, conducting serosurveys, studying non-infectious diseases and participating in clinical trials. CONCLUSION This article provides a vision of the future for blood services. The introduction of some of these changes will be slower in LMICs, where addressing key operational challenges will likely be prioritized.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montreal, Quebec, Canada
- Medicine faculty and health science, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Eunike McGowan
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Australia
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | | | - Lilian Antwi Boateng
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Immunohaematology laboratory, University Health Services, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Saikat Mandal
- Medical Oncology, Hull York Medical School, University of Hull, Hull, UK
| | - Nour Almozain
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jannison Ribeiro
- Centro de Hematologia e Hemoterapia do Ceará - Hemoce, Fortaleza, Brazil
- Instituto Pró-Hemo Saúde - IPH, Fortaleza, Brazil
| | - Syeldy Langi Sasongko
- Department of Public and Occupational Health, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
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Budama-Kilinc Y, Kurtur OB, Gok B, Cakmakci N, Kecel-Gunduz S, Unel NM, Ozturk TK. Use of Immunoglobulin Y Antibodies: Biosensor-based Diagnostic Systems and Prophylactic and Therapeutic Drug Delivery Systems for Viral Respiratory Diseases. Curr Top Med Chem 2024; 24:973-985. [PMID: 38561616 DOI: 10.2174/0115680266289898240322073258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/02/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
Respiratory viruses have caused many pandemics from past to present and are among the top global public health problems due to their rate of spread. The recently experienced COVID-19 pandemic has led to an understanding of the importance of rapid diagnostic tests to prevent epidemics and the difficulties of developing new vaccines. On the other hand, the emergence of resistance to existing antiviral drugs during the treatment process poses a major problem for society and global health systems. Therefore, there is a need for new approaches for the diagnosis, prophylaxis, and treatment of existing or new types of respiratory viruses. Immunoglobulin Y antibodies (IgYs) obtained from the yolk of poultry eggs have significant advantages, such as high production volumes, low production costs, and high selectivity, which enable the development of innovative and strategic products. Especially in diagnosing respiratory viruses, antibody-based biosensors in which these antibodies are integrated have the potential to provide superiority in making rapid and accurate diagnosis as a practical diagnostic tool. This review article aims to provide information on using IgY antibodies in diagnostic, prophylactic, and therapeutic applications for respiratory viruses and to provide a perspective for future innovative applications.
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Affiliation(s)
- Yasemin Budama-Kilinc
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkiye
- Health Biotechnology Joint Research and Application Center of Excellence, Istanbul, Turkey
| | - Ozan Baris Kurtur
- Graduate School of Natural and Applied Science, Yildiz Technical University, Istanbul, Turkey
| | - Bahar Gok
- Graduate School of Natural and Applied Science, Yildiz Technical University, Istanbul, Turkey
| | - Nisanur Cakmakci
- Graduate School of Natural and Applied Science, Yildiz Technical University, Istanbul, Turkey
| | - Serda Kecel-Gunduz
- Physics Department, Faculty of Science, Istanbul University, Istanbul, Turkiye
| | - Necdet Mehmet Unel
- Department of Genetics and Bioengineering, Faculty of Engineering and Architecture, Kastamonu University, Plantomics Research Laboratory, Kastamonu, Turkiye
- Research and Application Center, Kastamonu University, Kastamonu, Turkiye
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Suzuki T, Asai Y, Takahashi K, Sanada M, Shimanishi Y, Terada M, Sato L, Inada M, Yamada G, Akiyama Y, Oshiro Y, Shiratori K, Togano T, Takamatsu Y, Kenji M, Matsunaga A, Ishizaka Y, Nomoto H, Iwamoto N, Saito S, Kutsuna S, Morioka S, Ohmagari N. Trends of participants in convalescent plasma donation for COVID-19 in Japan as the pandemic evolved. Heliyon 2023; 9:e20568. [PMID: 37842585 PMCID: PMC10568336 DOI: 10.1016/j.heliyon.2023.e20568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Background We aimed to investigate chronological changes in the characteristics of participants in a coronavirus disease 2019 convalescent plasma donation study that may benefit optimal collection methods in the future. Methods Data from a convalescent plasma donation study from April 30, 2020 to November 5, 2021 were collected and analyzed. After August 23, 2021, an interim analysis of factors linked to higher antibody titers led us to restrict our participant recruitment criteria to participants who were within 4 months of disease onset and to patients who were otherwise most likely to have sufficiently high antibody titers. Overall, 1299 samples from 1179 patients were analyzed. Results Over the duration of the study, 35.9% of the samples were deemed eligible for convalescent plasma collection. The overall eligibility rate initially declined, dipping to <20% after one year. During this period, the proportion of enrolled samples from patients who had severe illness also declined, and the proportion of samples from participants who were >120 days post disease onset increased. After the addition of days from onset and vaccination status to our participant recruitment criteria, the eligibility rate improved significantly. Conclusions As outbreaks of emerging infectious disease occur, it is desirable to construct and implement a scheme for convalescent plasma donation promptly and to monitor the eligibility rate over time. If it declines, promptly analyze and resolve the associated factors. Additionally, vaccine development and infection prevalence are likely to influence the effective recruitment of participants with high antibody titers.
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Affiliation(s)
- Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yusuke Asai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kozue Takahashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Mio Sanada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Shimanishi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Oshiro
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuyuki Shiratori
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maeda Kenji
- Department of Refractory Viral Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
- Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Infection Control, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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Beneti SC, Marques LLM, Mattos G, Cardoso FAR. Use of convalescent plasma to treat COVID-19: case studies. BRAZ J BIOL 2023; 83:e262897. [PMID: 37493679 DOI: 10.1590/1519-6984.262897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/11/2022] [Indexed: 07/27/2023] Open
Abstract
There have been several efforts to minimize the effects caused by the COVID-19 virus around the world. Vaccines were developed in record time and alternative therapies were studied and applied in several countries, such as the use of plasma from recovered patients. Identifying, systematically evaluating and summarizing the best available scientific evidence on the efficacy and safety of using plasma from recovered COVID-19 patients remains the objective of this study. The studies carried out showed that the application of convalescent plasma contributes to the reduction of mortality, viral load and length of hospital stay. However, the effectiveness of the therapy still raises doubts due to the number of patients evaluated in clinical studies, in addition to its high cost and limitations in terms of availability and implementation, with the drug being authorized only for hospital use.
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Affiliation(s)
- Stéphani Caroline Beneti
- Universidade Tecnológica Federal do Paraná - UTFPR, Departamento Acadêmico de Alimentos e Engenharia Química, Campo Mourão, PR, Brasil
| | - Leila Larisa Medeiros Marques
- Universidade Tecnológica Federal do Paraná - UTFPR, Departamento Acadêmico de Alimentos e Engenharia Química, Campo Mourão, PR, Brasil
| | - Gisely Mattos
- Universidade Tecnológica Federal do Paraná - UTFPR, Programa de Pós-graduação em Inovações Tecnológicas - PPGIT, Campo Mourão, PR, Brasil
| | - Flávia Aparecida Reitz Cardoso
- Universidade Tecnológica Federal do Paraná - UTFPR, Programa de Pós-graduação em Inovações Tecnológicas - PPGIT, Campo Mourão, PR, Brasil
- Universidade Tecnológica Federal do Paraná - UTFPR, Programa de Pós-graduação em Tecnologia de Alimentos - PPGTA, Campo Mourão, PR, Brasil
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Uzun G, Müller R, Althaus K, Becker M, Marsall P, Junker D, Nowak-Harnau S, Schneiderhan-Marra N, Klüter H, Schrezenmeier H, Bugert P, Bakchoul T. Correlation between Clinical Characteristics and Antibody Levels in COVID-19 Convalescent Plasma Donor Candidates. Viruses 2023; 15:1357. [PMID: 37376656 DOI: 10.3390/v15061357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
COVID-19 convalescent plasma (CCP) with high neutralizing antibodies has been suggested in preventing disease progression in COVID-19. In this study, we investigated the relationship between clinical donor characteristics and neutralizing anti-SARS-CoV-2 antibodies in CCP donors. COVID-19 convalescent plasma donors were included into the study. Clinical parameters were recorded and anti-SARS-CoV-2 antibody levels (Spike Trimer, Receptor Binding Domain (RBD), S1, S2 and nucleocapsid protein) as well as ACE2 binding inhibition were measured. An ACE2 binding inhibition < 20% was defined as an inadequate neutralization capacity. Univariate and multivariable logistic regression analysis was used to detect the predictors of inadequate neutralization capacity. Ninety-one CCP donors (56 female; 61%) were analyzed. A robust correlation between all SARS-CoV-2 IgG antibodies and ACE2 binding inhibition, as well as a positive correlation between donor age, body mass index, and a negative correlation between time since symptom onset and antibody levels were found. We identified time since symptom onset, normal body mass index (BMI), and the absence of high fever as independent predictors of inadequate neutralization capacity. Gender, duration of symptoms, and number of symptoms were not associated with SARS-CoV-2 IgG antibody levels or neutralization. Neutralizing capacity was correlated with SARS-CoV-2 IgG antibodies and associated with time since symptom onset, BMI, and fever. These clinical parameters can be easily incorporated into the preselection of CCP donors.
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Affiliation(s)
- Günalp Uzun
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Rebecca Müller
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Karina Althaus
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Patrick Marsall
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Stefanie Nowak-Harnau
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Nicole Schneiderhan-Marra
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, 89081 Ulm, Germany
- Institute for Transfusion Medicine and University Hospital Ulm, University of Ulm, 89081 Ulm, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Tamam Bakchoul
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
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Moubarak M, Kasozi KI, Hetta HF, Shaheen HM, Rauf A, Al-kuraishy HM, Qusti S, Alshammari EM, Ayikobua ET, Ssempijja F, Afodun AM, Kenganzi R, Usman IM, Ochieng JJ, Osuwat LO, Matama K, Al-Gareeb AI, Kairania E, Musenero M, Welburn SC, Batiha GES. The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections. Life (Basel) 2021; 11:734. [PMID: 34440478 PMCID: PMC8399171 DOI: 10.3390/life11080734] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Novel therapies for the treatment of COVID-19 are continuing to emerge as the SARS-Cov-2 pandemic progresses. PCR remains the standard benchmark for initial diagnosis of COVID-19 infection, while advances in immunological profiling are guiding clinical treatment. The SARS-Cov-2 virus has undergone multiple mutations since its emergence in 2019, resulting in changes in virulence that have impacted on disease severity globally. The emergence of more virulent variants of SARS-Cov-2 remains challenging for effective disease control during this pandemic. Major variants identified to date include B.1.1.7, B.1.351; P.1; B.1.617.2; B.1.427; P.2; P.3; B.1.525; and C.37. Globally, large unvaccinated populations increase the risk of more and more variants arising. With successive waves of COVID-19 emerging, strategies that mitigate against community transmission need to be implemented, including increased vaccination coverage. For treatment, convalescent plasma therapy, successfully deployed during recent Ebola outbreaks and for H1N1 influenza, can increase survival rates and improve host responses to viral challenge. Convalescent plasma is rich with cytokines (IL-1β, IL-2, IL-6, IL-17, and IL-8), CCL2, and TNFα, neutralizing antibodies, and clotting factors essential for the management of SARS-CoV-2 infection. Clinical trials can inform and guide treatment policy, leading to mainstream adoption of convalescent therapy. This review examines the limited number of clinical trials published, to date that have deployed this therapy and explores clinical trials in progress for the treatment of COVID-19.
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Affiliation(s)
- Mohamed Moubarak
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
| | - Keneth Iceland Kasozi
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
- School of Medicine, Kabale University, Kabale P.O. Box 317, Uganda
| | - Helal F. Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Hazem M. Shaheen
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
| | - Abdur Rauf
- Department of Chemistry, University of Swabi, Swabi 23561, Pakistan;
| | - Hayder M. Al-kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyia University, P.O. Box 14022 Baghdad, Iraq;
| | - Safaa Qusti
- Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Eida M. Alshammari
- Department of Chemistry, College of Sciences, University of Ha’il, Ha’il 2440, Saudi Arabia;
| | - Emmanuel Tiyo Ayikobua
- School of Health Sciences, Soroti University, Soroti P.O. Box 211, Uganda; (E.T.A.); (L.O.O.)
| | - Fred Ssempijja
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Adam Moyosore Afodun
- Department of Anatomy and Cell Biology, Faculty of Health Sciences, Busitema University, Tororo P.O. Box 236, Uganda; (A.M.A.); (E.K.)
| | - Ritah Kenganzi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Kampala International University Teaching Hospital, Bushenyi P.O. Box 71, Uganda;
| | - Ibe Michael Usman
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Juma John Ochieng
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Lawrence Obado Osuwat
- School of Health Sciences, Soroti University, Soroti P.O. Box 211, Uganda; (E.T.A.); (L.O.O.)
| | - Kevin Matama
- School of Pharmacy, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda;
| | - Ali I. Al-Gareeb
- Department of Pharmacology, Toxicology and Medicine, College of Medicine Al-Mustansiriya University, Baghdad P.O. Box 14022, Iraq;
| | - Emmanuel Kairania
- Department of Anatomy and Cell Biology, Faculty of Health Sciences, Busitema University, Tororo P.O. Box 236, Uganda; (A.M.A.); (E.K.)
| | - Monica Musenero
- Ministry of Science Technology and Innovations, Government of Uganda, Kampala P.O. Box 7466, Uganda;
| | - Susan Christina Welburn
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining 314400, China
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
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Sharma S, Jeyaraman M, Muthu S, Anudeep TC, Jeyaraman N, Shringeri AS, Kumar V, Somasundaram R, Jain R, Jha SK. A Step Toward Optimizing Regenerative Medicine Principle to Combat COVID-19. ANNALS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES (INDIA) 2021. [DOI: 10.1055/s-0041-1731597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AbstractDrugs are currently not licensed in specific to pulverize COVID-19. On an emergency basis, vaccines were approved to prevent the further spread of COVID-19. This serves as a potential background for considering the optimization of biologics. In this context, evidence on convalescent plasma and stem cells has shown a beneficial role. Here, we have considered this as plausible therapy, and further hypothesize that their cocktails will synergistically boost the immunogenicity to relegate COVID-19. This warrants a large volume clinical trial on an emergent basis, because the sooner we establish a safe and effective cure, the better.
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Affiliation(s)
- Shilpa Sharma
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Madhan Jeyaraman
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Sathish Muthu
- Department of Orthopaedics, Government Medical College and Hospital, Dindigul, Tamil Nadu, India
| | - Talagavadi Channaiah Anudeep
- Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Naveen Jeyaraman
- Department of Orthopaedics, Kasturba Medical College, MAHE University, Manipal, Karnataka, India
| | | | | | | | - Rashmi Jain
- School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
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De Silvestro G, Gandini G, Fiorin F, Marson P, Barbone E, Frigato A, Gessoni G, Veronesi A, Pacenti M, Castelli M, Rinaldi M, Rizzi M, Stefani F, Roveroni G. Preparedness and activities of the anti-SARS-CoV-2 convalescent plasma bank in the Veneto region (Italy): An organizational model for future emergencies. Transfus Apher Sci 2021; 60:103154. [PMID: 33994107 PMCID: PMC8103741 DOI: 10.1016/j.transci.2021.103154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 02/02/2023]
Abstract
Background Convalescent plasma (CP) has been used in the past in various pandemics, in particular in H1N1, SARS and MERS infections. In Spring 2020, when ongoing the SARS-CoV-2 pandemics, the Veneto Region (V-R) has proposed setting-up an anti-SARS-CoV-2 CP (CCP) Bank, with the aim of preparing a supply of CCP immediately available in case of subsequest epidemic waves. Materials and Methods Key-points to be developed for a quick set-up of the V-R CCP Bank have been recruitment of donors recovered from COVID-19 infection, laboratory analysis for the biological qualification of the CCP units, including titre of neutralizing antibodies and reduction of pathogens, according to National Blood Centre (CNS) Directives, adaptation of the V-R Information Technology systems and cost analysis. Some activities, including diagnostic and viral inactivation processes, have been centralized in 2 or 3 sites. Laboratory analysis upon preliminary admission of the donor included all tests required by the Italian laws and the CNS directives. Results From April to August 2020, 3,298 people have contacted the V-R Blood Transfusion Services: of these, 1,632 have been evaluated and examined as first time donors and those found to be suitable have carried out 955 donations, from which 2,626 therapeutic fractions have been obtained, at a cost around 215,00 Euro. Since October 2020, the number of COVID-19 inpatients has had a surge with a heavy hospital overload. Moreover, the high request of CCP therapy by clinicians has been just as unexpected, showing a wide therapeutic use. Conclusions The organizational model here presented, which has allowed the rapid collection of a large amount of CCP, could be useful when facing new pandemic outbreaks, especially in low and middle income countries, with generally acceptable costs.
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Affiliation(s)
| | - Giorgio Gandini
- Transfusion Medicine Department of Verona, University Hospital of Verona, Italy
| | - Francesco Fiorin
- Transfusion Medicine Department of Vicenza, San Bortolo Hospital of Vicenza, Italy
| | - Piero Marson
- Transfusion Medicine Department of Padova, University Hospital of Padova, Italy
| | - Ersilia Barbone
- Transfusion Medicine Department of Belluno, San Martino Hospital of Belluno, Italy
| | - Andrea Frigato
- Transfusion Medicine Department of Rovigo, S. Maria della Misericordia Hospital of Rovigo, Italy
| | - Gianluca Gessoni
- Transfusion Medicine Department of Venezia, Dell'Angelo Hospital of Mestre (Venice), Italy
| | - Arianna Veronesi
- Transfusion Medicine Department of Treviso, Ca' Foncello Hospital of Treviso, Italy
| | - Monia Pacenti
- Institute of Microbiology and Virology, University Hospital of Padova, Italy
| | - Monica Castelli
- Transfusion Medicine Department of Vicenza, San Bortolo Hospital of Vicenza, Italy
| | - Marianna Rinaldi
- Transfusion Medicine Department of Verona, University Hospital of Verona, Italy
| | - Monica Rizzi
- Transfusion Medicine Department of Verona, University Hospital of Verona, Italy
| | - Francesca Stefani
- Transfusion Medicine Department of Vicenza, San Bortolo Hospital of Vicenza, Italy
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9
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Gammon RR, Prichard AB, Gannett MS, Yordanov B. The effect of COVID-19 on blood donation habits. Transfusion 2021; 61:1134-1140. [PMID: 33565620 PMCID: PMC8014865 DOI: 10.1111/trf.16278] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Blood centers (BCs) rely on schools and businesses. Shelter-in-place orders closed them. This study determined how COVID-19 affected donation habits. STUDY DESIGN AND METHODS Two periods were reviewed (May 1 through June 30, 2018 vs 2019 [control] and 2019 vs 2020 [study-COVID period]). These donations were reviewed: first-time, repeat (donation ≤ 2 years), and lapsed (no donation > 2 years); sex; age; ethnicity; and ABO blood groups at high school and college drives. Testing all donors for SARS-CoV-2 antibodies started May 18, 2020. RESULTS In the study period donations significantly increased (control P = .683, study P ≤ .0001) and comparing sex (control male P = .716, female P = .657; study male P = .004, female P ≤ .0001). In the study period there was a significant decrease in Hispanic (P = .001) and African American (P < .0001) donations also seen among high school and college drives and an increase in Caucasian (P < .0001) donations. There was a significant increase in first-time (P < .0001) and lapsed donors (P < .0001) in the study period vs control (first-time P = .087, lapsed P = .308) and a significant decrease in donors not more than 30 years (study 16-20 P < .0001, 21-30 P < .0001). There was a significant increase in all blood types in the study period (P < .0001) and in donations after implementation of SARS-CoV-2 antibody testing (P = .001). CONCLUSIONS Significant changes occurred in donation habits in the study vs the control periods. These included increased total donations, comparing sexes, first-time and lapsed donors, all blood types, and Caucasian donations. Significant decreases were seen in Hispanic and African American donations and those not more than 30 years old.
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Affiliation(s)
- Richard R Gammon
- OneBlood, Scientific, Medical, Technical Direction, Orlando, Florida, USA
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10
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Szakó L, Farkas N, Kiss S, Váncsa S, Zádori N, Vörhendi N, Erőss B, Hegyi P, Alizadeh H. Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials. Trials 2021; 22:112. [PMID: 33522939 PMCID: PMC7848881 DOI: 10.1186/s13063-021-05066-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/20/2021] [Indexed: 12/15/2022] Open
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.
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Affiliation(s)
- Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Szabolcs Kiss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Noémi Zádori
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Nóra Vörhendi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- First Department of Medicine, Medical School, University of Szeged, Szeged, Hungary
| | - Hussain Alizadeh
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
- Division of Hematology, First Department of Medicine, Medical School, University of Pécs, Ifjúság street 13, Pécs, H-7624 Hungary
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11
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Al‐Riyami AZ, Schäfer R, van den Berg K, Bloch EM, Estcourt LJ, Goel R, Hindawi S, Josephson CD, Land K, McQuilten ZK, Spitalnik SL, Wood EM, Devine DV, So‐Osman C. Clinical use of Convalescent Plasma in the COVID-19 pandemic: a transfusion-focussed gap analysis with recommendations for future research priorities. Vox Sang 2021; 116:88-98. [PMID: 32542847 PMCID: PMC7891452 DOI: 10.1111/vox.12973] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Use of convalescent plasma for coronavirus disease 2019 (COVID-19) treatment has gained interest worldwide. However, there is lack of evidence on its dosing, safety and effectiveness. Until data from clinical studies are available to provide solid evidence for worldwide applicable guidelines, there is a need to provide guidance to the transfusion community and researchers on this emergent therapeutic option. This paper aims to identify existing key gaps in current knowledge in the clinical application of COVID-19 convalescent plasma (CCP). MATERIALS AND METHODS The International Society of Blood Transfusion (ISBT) initiated a multidisciplinary working group with worldwide representation from all six continents with the aim of reviewing existing practices on CCP use from donor, product and patient perspectives. A subgroup of clinical transfusion professionals was formed to draft a document for CCP clinical application to identify the gaps in knowledge in existing literature. RESULTS Gaps in knowledge were identified in the following main domains: study design, patient eligibility, CCP dose, frequency and timing of CCP administration, parameters to assess response to CCP treatment and long-term outcome, adverse events and CCP application in less-resourced countries as well as in paediatrics and neonates. CONCLUSION This paper outlines a framework of gaps in the knowledge of clinical deployment of CPP that were identified as being most relevant. Studies to address the identified gaps are required to provide better evidence on the effectiveness and safety of CCP use.
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Affiliation(s)
- Arwa Z. Al‐Riyami
- Department of HaematologySultan Qaboos University HospitalMuscatSultanate of Oman
| | - Richard Schäfer
- Institute for Transfusion Medicine and ImmunohaematologyGerman Red Cross Blood Donor Service Baden‐Württemberg‐Hessen gGmbHGoethe University HospitalFrankfurt am MainGermany
| | - Karin van den Berg
- Medical DivisionTranslational Research DepartmentSouth African National Blood ServicePort ElizabethSouth Africa
- Division Clinical HaematologyDepartment of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Evan M. Bloch
- Department of PathologyJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Lise J. Estcourt
- Radcliffe Department of MedicineUniversity of Oxford and NHS Blood and TransplantOxfordUK
| | - Ruchika Goel
- Division of Transfusion MedicineDepartment of PathologyJohns Hopkins HospitalBaltimoreMDUSA
- Division of Hematology/OncologySimmons Cancer Institute at SIU School of Medicine and Mississippi Valley Regional Blood CenterSpringfieldILUSA
| | - Salwa Hindawi
- Haematology DepartmentFaculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Cassandra D. Josephson
- Department of Pathology and Laboratory MedicineCenter for Transfusion and Cellular TherapiesEmory University School of MedicineAtlantaGEUSA
- Department of PediatricsAflac Cancer Center and Blood DisordersChildren's Healthcare of AtlantaEmory University School of MedicineAtlantaGEUSA
| | - Kevin Land
- Corporate Medical AffairsVitalantPhoenixAZUSA
- Department of PathologyUT Health Science San AntonioSan AntonioTXUSA
| | - Zoe K. McQuilten
- Transfusion Research UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
- Department of Clinical HaematologyMonash HealthMelbourneVICAustralia
| | | | - Erica M. Wood
- Transfusion Research UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
- Department of Clinical HaematologyMonash HealthMelbourneVICAustralia
| | - Dana V. Devine
- Canadian Blood ServicesVancouverBCCanada
- Department of Pathology & Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Cynthia So‐Osman
- Department Unit Transfusion MedicineSanquin Blood Supply FoundationAmsterdamThe Netherlands
- Department HaematologyErasmus Medical CenterRotterdamThe Netherlands
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12
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Dzimianski JV, Lorig-Roach N, O'Rourke SM, Alexander DL, Kimmey JM, DuBois RM. Rapid and sensitive detection of SARS-CoV-2 antibodies by biolayer interferometry. Sci Rep 2020; 10:21738. [PMID: 33303951 PMCID: PMC7730435 DOI: 10.1038/s41598-020-78895-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022] Open
Abstract
Serological testing to evaluate antigen-specific antibodies in plasma is generally performed by rapid lateral flow test strips that lack quantitative results or by high complexity immunoassays that are time- and labor-intensive but provide semi-quantitative results. Here, we describe a novel application of biolayer interferometry for the rapid detection of antigen-specific antibody levels in plasma samples, and demonstrate its utility for quantification of SARS-CoV-2 antibodies. Our biolayer interferometry immunosorbent assay (BLI-ISA) utilizes single-use biosensors in an automated "dip-and-read" format, providing real-time optical measurements of antigen loading, plasma antibody binding, and antibody isotype detection. Complete semi-quantitative results are obtained in less than 20 min. BLI-ISA meets or exceeds the performance of high complexity methods such as Enzyme-Linked Immunosorbent Assay (ELISA) and Chemiluminescent Immunoassay. Importantly, our method can be immediately implemented on existing BLI platforms for urgent COVID-19 studies, such as serosurveillance and the evaluation of vaccine candidates. In a broader sense, BLI-ISA can be developed as a novel diagnostic platform to evaluate antibodies and other biomolecules in clinical specimens.
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Affiliation(s)
- John V Dzimianski
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Nicholas Lorig-Roach
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Sara M O'Rourke
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
| | | | - Jacqueline M Kimmey
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Rebecca M DuBois
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA.
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13
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Skrip L, Derra K, Kaboré M, Noori N, Gansané A, Valéa I, Tinto H, Brice BW, Gordon MV, Hagedorn B, Hien H, Althouse BM, Wenger EA, Ouédraogo AL. Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis. Int J Infect Dis 2020; 101:194-200. [PMID: 32987177 PMCID: PMC7518969 DOI: 10.1016/j.ijid.2020.09.1432] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/13/2020] [Accepted: 09/22/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Absolute numbers of COVID-19 cases and deaths reported to date in the sub-Saharan Africa (SSA) region have been significantly lower than those across the Americas, Asia and Europe. As a result, there has been limited information about the demographic and clinical characteristics of deceased cases in the region, as well as the impacts of different case management strategies. METHODS Data from deceased cases reported across SSA through 10 May 2020 and from hospitalized cases in Burkina Faso through 15 April 2020 were analyzed. Demographic, epidemiological and clinical information on deceased cases in SSA was derived through a line-list of publicly available information and, for cases in Burkina Faso, from aggregate records at the Centre Hospitalier Universitaire de Tengandogo in Ouagadougou. A synthetic case population was probabilistically derived using distributions of age, sex and underlying conditions from populations of West African countries to assess individual risk factors and treatment effect sizes. Logistic regression analysis was conducted to evaluate the adjusted odds of survival for patients receiving oxygen therapy or convalescent plasma, based on therapeutic effectiveness observed for other respiratory illnesses. RESULTS Across SSA, deceased cases for which demographic data were available were predominantly male (63/103, 61.2%) and aged >50 years (59/75, 78.7%). In Burkina Faso, specifically, the majority of deceased cases either did not seek care at all or were hospitalized for a single day (59.4%, 19/32). Hypertension and diabetes were often reported as underlying conditions. After adjustment for sex, age and underlying conditions in the synthetic case population, the odds of mortality for cases not receiving oxygen therapy were significantly higher than for those receiving oxygen, such as due to disruptions to standard care (OR 2.07; 95% CI 1.56-2.75). Cases receiving convalescent plasma had 50% reduced odds of mortality than those who did not (95% CI 0.24-0.93). CONCLUSIONS Investment in sustainable production and maintenance of supplies for oxygen therapy, along with messaging around early and appropriate use for healthcare providers, caregivers and patients could reduce COVID-19 deaths in SSA. Further investigation into convalescent plasma is warranted until data on its effectiveness specifically in treating COVID-19 becomes available. The success of supportive or curative clinical interventions will depend on earlier treatment seeking, such that community engagement and risk communication will be critical components of the response.
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Affiliation(s)
- Laura Skrip
- Institute for Disease Modeling, Bellevue, WA, USA.
| | - Karim Derra
- IRSS-Clinical Research Unit of Nanoro, Burkina Faso
| | - Mikaila Kaboré
- Ministry of Health, Teaching Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | | | - Adama Gansané
- Centre National de Recherche et de Formation Sur le Paludisme, National Public Health Institute, Ouagadougou, Burkina Faso
| | | | | | - Bicaba W Brice
- Centre des Operations de Réponses aux Urgences Sanitaires, Ouagadougou, National Public Health Institute, Burkina Faso
| | | | | | - Hervé Hien
- Centre MURAZ, National Public Health Institute, Ouagadougou, Burkina Faso; IRSS, Programme de Recherche Sur les Politiques et les Systèmes de Santé, Bobo-Dioulasso, Burkina Faso
| | - Benjamin M Althouse
- Institute for Disease Modeling, Bellevue, WA, USA; University of Washington, Seattle, WA, USA; New Mexico State University, Las Cruces, NM, USA
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14
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Hassan MO, Osman AA, Elbasit HEA, Hassan HE, Rufai H, Satti MMM, Elnegoumi M, Idris R, Musa A, Ali AH, Zroog SA, Altayb ADA, Khairy A, Allam M, Abdelhalim ATI. Convalescent plasma as a treatment modality for coronavirus disease 2019 in Sudan. Transfus Apher Sci 2020; 59:102918. [PMID: 32900597 PMCID: PMC7450236 DOI: 10.1016/j.transci.2020.102918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a disease spreading rapidly in Sudan, the rest of the African continent and the world with no known definitive treatment or vaccines. However, among many treatment interventions being tested globally, beneficial effects and clinical improvements have been reported when convalescent plasma is used for treating COVID-19 patients. We prepared a guiding protocol for treating early to moderate COVID-19 patients with plasma transfusion from convalescent COVID-19 patients. This protocol was deduced based on previously published reports and studies that evaluated and tested convalescent plasma as a prospective therapy for COVID-19 patients. The protocol covers instructions on patient and donor selection criteria, plasma harvesting, plasma product specifications, dosage and precautions for convalescent plasma collection and transfusion process. Altogether, we prepared a treatment protocol that is tailored to the context of Sudan to be adopted by Sudan's health authority. Moreover, it will also provide reference for researchers to design open label clinical trials for convalescent plasma transfusion.
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Affiliation(s)
- Mozan Osman Hassan
- Faculty of Medical Laboratory Science, Omdurman Ahlia University, Sudan.
| | - Asma Ahmed Osman
- Faculty of Medicine and Health Science, Omdurman Islamic University, Sudan
| | | | | | - Hala Rufai
- National Blood Transfusion Services, Federal Ministry of Health, Sudan
| | - Maria M M Satti
- National Blood Transfusion Services, Federal Ministry of Health, Sudan
| | - Musab Elnegoumi
- Diseases Control Directorate, Federal Ministry of Health, Sudan
| | - Roaa Idris
- University of Wolverhampton, United Kingdom
| | | | - Abdelhakam H Ali
- Faculty of Medical Laboratory Science, University of Al Butana, Sudan
| | - Susan Ali Zroog
- Faculty of Applied Medical Science, University of Al Butana, Sudan
| | | | - Amna Khairy
- Diseases Control Directorate, Federal Ministry of Health, Sudan
| | - Mushal Allam
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
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15
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Samad N, Sodunke TE, Banna HA, Sapkota A, Fatema AN, Iskandar K, Jahan D, Hardcastle TC, Nusrat T, Chowdhury TS, Haque M. Convalescent Plasma Therapy for Management of COVID-19: Perspectives and Deployment in the Current Global Pandemic. Risk Manag Healthc Policy 2020; 13:2707-2728. [PMID: 33262668 PMCID: PMC7695687 DOI: 10.2147/rmhp.s281388] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/29/2020] [Indexed: 12/15/2022] Open
Abstract
The world is striving against the severe crisis of the COVID-19 pandemic. Healthcare professionals are struggling to treat their patients based on nonspecific therapies. Amidst this uncertainty, convalescent plasma therapy (CPT) has appeared to be an interim adjuvant therapy for severely ill patients of COVID-19 until long-term clinical trial treatment options are available. Considering the transfusion-related hazards, especially lung injuries and microbial transmission, where sensitivity is not ensured, rigorous trials should be conducted to determine this therapy's efficacy. Moreover, the ratio of recovered cases to plasma donors is not satisfying, which questioning this therapy's availability and accessibility. Although some countries are making the treatment free, the attributable cost mandates a justification for its suitability and sustainability. Our article aimed to review the published facts and findings of CPT's effectiveness in lowering the mortality rate of COVID-19. This pandemic showed that healthcare systems worldwide need core reform. A unified global collaboration must align and coordinate to face the current pandemic and enhance world readiness for future outbreaks based on health equity and equality.
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Affiliation(s)
- Nandeeta Samad
- Department of Public Health, North South University, Dhaka1229, Bangladesh
| | | | - Hasan Al Banna
- Institute of Social Welfare and Research, University of Dhaka, Dhaka1000, Bangladesh
| | - Ashmita Sapkota
- Department of Microbiology, Mahidol University, Ratchathewi, Bangkok10400, Thailand
| | | | - Katia Iskandar
- School of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, Dhaka1204, Bangladesh
| | - Timothy Craig Hardcastle
- Department of Surgery, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Umbilo, Berea4001, South Africa
| | - Tanzina Nusrat
- Department of Microbiology, Chittagong Medical College, Chattogram4203, Bangladesh
| | | | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur57000, Malaysia
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16
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Bai H, Ji Y, Wang J, Zhang X. Efficacy of human coronavirus immune convalescent plasma for the treatment of corona virus disease -19 disease in hospitalized children: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e22017. [PMID: 33157910 PMCID: PMC7647599 DOI: 10.1097/md.0000000000022017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 viral infection resulting in corona virus disease 2019 (COVID-19) disease has recently been designated by the World Health Organization as a global pandemic. Some doctors are using convalescent plasma (CP) therapies to treat COVID-19 patients. However, whether CP therapy is effective for children with COVID-19 remains controversial. Therefore, this study further explores the effectiveness and safety of human coronavirus immune CP in the treatment of COVID-19 in children. METHODS Comprehensively search the electronic databases such as the Cochrane Library, PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, and WanFang, and collect relevant documents. We will also look for other sources. All document sources will not be restricted by language and publication status. Two researchers will independently conduct research selection, data extraction and research quality assessment. RevMan 5.3 was used for statistical analysis. RESULTS This study will provide high-quality comprehensive evidence for the effectiveness and safety of human coronavirus immuno CP in the treatment of COVID-19 in children CONCLUSIONS:: The results of this study will provide the basis for the effectiveness and safety of human coronavirus immuno CP treatment of COVID-19 in children. PROSPERO REGISTRATION NUMBER CRD42020199410.
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Affiliation(s)
- Hua Bai
- General Hospital of Ningxia Medical University
| | - Yongjia Ji
- Ningxia Maternal and Child Health Care Hospital (Ningxia Children's Hospital), Ningxia
| | - Jia Wang
- General Hospital of Ningxia Medical University
| | - Xuehong Zhang
- Huazhong university of science and technology union shenzhen hospital, Shenzhen, China
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17
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Deitrick K, Adams J, Davis J. Emergency Nursing Care of Patients With Novel Coronavirus Disease 2019. J Emerg Nurs 2020; 46:748-759. [PMID: 32972766 PMCID: PMC7368907 DOI: 10.1016/j.jen.2020.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
Novel coronavirus disease 2019 is the disease caused by the novel coronavirus originally from Wuhan, China. Its pathophysiology is poorly understood, but it is known to be contagious and deadly. Multiple symptoms and complications from the disease have been described, with the most common complaints being respiratory. Nursing care of patients with novel coronavirus disease 2019 is largely supportive, but it should include a strong focus on mitigating the spread of infection to staff, other patients, and the community.
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18
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Ojha S, Chadha H, Mahor S. COVID-19: Pathogenesis and Pharmacological Basis for Use of Passive Antibody Therapy. CURRENT DRUG THERAPY 2020. [DOI: 10.2174/1574885515999200813193747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background:
Coronaviruses (CoVs), having enveloped RNA of positive strand, are
mainly responsible for enzootic infections in mammals. The mortality of CoVs has been proved as
they can cross the species barrier very easily and infect humans. Most recently, the outbreak of
coronavirus induced COVID-19 emerged in the city of Wuhan, Hubei province of China and became
the third highly pathogenic coronavirus infecting nearly 230 countries.
Objective:
To review the literature available about pathogenic Coronavirures with emphasis on
pathogenesis of COVID-19, and passive antibody therapy prospective.
Methods:
This study reviewed relevant published literature to provide (1) structural similarities
between coronaviruses and therapeutic methodologies used on SARS-CoV, MERS treatment which
might help scientists in understanding novel COVID-19 infection, (2) understanding COVID-19
pathogenesis that may help in identification of appropriate therapeutic targets to develop specific
and effective anti-viral drugs as well as immunizing agents against this novel emerging pathogen
and (3) to discuss existing knowledge on the passive immune therapy against similar coronaviruses
SARS-CoV and MERS-CoV with emphasis on COVID-19 pandemic treatment.
Conclusion:
COVID 19 coronavirus has shown resemblance to viral infections like SARS-CoV,
MERS infection. Historically, it has been proved that the prevention of disease, when exposed to a
biological system, is mainly a function of the immune response of that infected individual. To fight
against these infections, passive antibody therapy is the only available countermeasure that could
provide immediate immunity against infection. Passive antibody results in protection irrespective of
the immune status of the host. This therapy can be advantageous in countering the biological attack,
post exposure preventions, low toxicity and peculiar activity.
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Affiliation(s)
- Smriti Ojha
- Faculty of Pharmacy, Sardar Patel College of Pharmacy, Gorakhpur, Uttar Pradesh, India
| | - Hina Chadha
- Department of Pharmaceutical Sciences, Vishveshwarya Group of Institutions, Greater Noida, Uttar Pradesh, India
| | - Seema Mahor
- Department of Pharmaceutical Sciences, Vishveshwarya Group of Institutions, Greater Noida, Uttar Pradesh, India
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19
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Pan X, Dong L, Yang L, Chen D, Peng C. Potential drugs for the treatment of the novel coronavirus pneumonia (COVID-19) in China. Virus Res 2020; 286:198057. [PMID: 32531236 PMCID: PMC7282797 DOI: 10.1016/j.virusres.2020.198057] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/15/2020] [Accepted: 06/07/2020] [Indexed: 12/27/2022]
Abstract
The fight against the novel coronavirus pneumonia (namely COVID-19) that seriously harms human health is a common task for all mankind. Currently, development of drugs against the novel coronavirus (namely SARS-CoV-2) is quite urgent. Chinese medical workers and scientific researchers have found some drugs to play potential therapeutic effects on COVID-19 at the cellular level or in preliminary clinical trials. However, more fundamental studies and large sample clinical trials need to be done to ensure the efficacy and safety of these drugs. The adoption of these drugs without further testing must be careful. The relevant articles, news, and government reports published on the official and Preprint websites, PubMed and China National Knowledge Infrastructure (CNKI) databases from December 2019 to April 2020 were searched and manually filtered. The general pharmacological characteristics, indications, adverse reactions, general usage, and especially current status of the treatment of COVID-19 of those potentially effective drugs, including chemical drugs, traditional Chinese medicines (TCMs), and biological products in China were summarized in this review to guide reasonable medication and the development of specific drugs for the treatment of COVID-19.
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Affiliation(s)
- Xiaoqi Pan
- School of Public Health and School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Lan Dong
- The Third People's Hospital of Chengdu, Chengdu, 610031, China
| | - Lian Yang
- School of Public Health and School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Dayi Chen
- School of Public Health and School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Cheng Peng
- School of Public Health and School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
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A potentially effective treatment for COVID-19: A systematic review and meta-analysis of convalescent plasma therapy in treating severe infectious disease. Int J Infect Dis 2020; 98:334-346. [PMID: 32634589 PMCID: PMC7334933 DOI: 10.1016/j.ijid.2020.06.107] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Convalescent plasma (CP) has been used successfully to treat many types of infectious disease, and has shown initial effects in the treatment of the emerging 2019 coronavirus disease (COVID-19). However, its curative effects and feasibility have yet to be confirmed by formal evaluation and well-designed clinical trials. To explore the effectiveness of treatment and predict the potential effects of CP with COVID-19, studies of different types of infectious disease treated with CP were included in this systematic review and meta-analysis. METHODS Related studies were obtained from databases and screened according to the inclusion criteria. The data quality was assessed, and the data were extracted and pooled for analysis. RESULTS 40 studies on CP treatment for infectious diseases were included. Our study found that CP treatment could reduce the risk of mortality, with a low incidence of adverse events, promote the production of antibodies, lead to a decline in viral load, and shorten the disease course. A meta-analysis of 15 controlled studies showed that there was a significantly lower mortality rate in the group treated with CP (pooled OR=0.32; 95% CI=0.19-0.52; p<0.001, I2=54%) compared with the control groups. Studies were mostly of low or very low quality, with a moderate or high risk of bias. The sources of clinical and methodological heterogeneity were identified. The exclusion of heterogeneity indicated that the results were stable. CONCLUSIONS CP therapy has some curative effect and is well tolerated in treating infectious diseases. It is a potentially effective treatment for COVID-19.
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Liu M, Chen Z, Dai MY, Yang JH, Chen XB, Chen D, You H, Guo X, Leng Y, Yu L, Zhang ML, Wu X, Yang J, Gao C, Tenen DG, Chai L, Ai F. Lessons learned from early compassionate use of convalescent plasma on critically ill patients with Covid-19. Transfusion 2020; 60:2210-2216. [PMID: 32770691 PMCID: PMC7436937 DOI: 10.1111/trf.15975] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/21/2020] [Accepted: 06/21/2020] [Indexed: 01/08/2023]
Abstract
Background The management of critically ill patients with coronavirus disease 2019 (COVID‐19), caused by a new human virus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is challenging. Recently, there have been several reports with inconsistent results after treatment with convalescent plasma (CP) on critically ill patients with COVID‐19, which was produced with a neutralizing antibody titer and tested in a P3 or P4 laboratory. However, due to the limitation of the conditions on mass production of plasma, most producers hardly had the capability to isolate the neutralizing antibody. Here, we report the clinical courses of three critically ill patients with COVID‐19 receiving CP treatments by total immunoglobulin G (IgG) titer collection. Methods Three patients with COVID‐19 in this study were laboratory confirmed to be positive for SARS‐CoV‐2, with radiographic and clinical features of pneumonia. CP was collected by total IgG titer of 160 (range, 200‐225 mL), and patients were transfused between 20 and 30 days after disease onset at the critical illness stage as a trial in addition to standard care. The clinical courses of these patients, including laboratory results and pulmonary functional and image studies after receiving convalescent plasma infusions, were reviewed. Results No therapeutic effect of CP was observed in any of the patients; instead, all three patients deteriorated and required extracorporeal membrane oxygenation treatment. A potential cytokine storm 4 hours after infusion of CP in Patient 2 was observed. No more patients were put on the trial of CP transfusion. Conclusions We recommend extreme caution in using CP in critically ill patients more than 2 weeks after the onset of COVID‐19 pneumonia.
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Affiliation(s)
- Miao Liu
- Department of Pathology, Transfusion Medicine Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Zhen Chen
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
| | - Meng-Yuan Dai
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun-Hui Yang
- Intensive Care Unit, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
| | - Xiao-Bing Chen
- Department of Emergency, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Di Chen
- Intensive Care Unit, Tongji Hospital Affiliated to Tongji Medical College of Hua Zhong University of Science and Technology, Wuhan, China
| | - Hua You
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Xin Guo
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
| | - Yan Leng
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Yu
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Meng-Li Zhang
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
| | - Xian Wu
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
| | - Junyu Yang
- Department of Pathology, Transfusion Medicine Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chong Gao
- Department of Pathology, Transfusion Medicine Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel G Tenen
- Harvard Stem Cell Institute, Harvard Medical School, Boston, Massachusetts, USA.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Li Chai
- Department of Pathology, Transfusion Medicine Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Fen Ai
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
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Soleimani Z, Soleimani A. ADRS due to COVID-19 in midterm pregnancy: successful management with plasma transfusion and corticosteroids. J Matern Fetal Neonatal Med 2020; 35:3040-3043. [DOI: 10.1080/14767058.2020.1797669] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Zahra Soleimani
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Fetal Health Research Center, Hope Generatin Foundation, Tehran, Iran
| | - Azam Soleimani
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Dzimianski JV, Lorig-Roach N, O’Rourke SM, Alexander DL, Kimmey JM, DuBois RM. Rapid and sensitive detection of SARS-CoV-2 antibodies by biolayer interferometry. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.07.17.20156281. [PMID: 32743612 PMCID: PMC7388487 DOI: 10.1101/2020.07.17.20156281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Serological testing to evaluate antigen-specific antibodies in plasma is generally performed by rapid lateral flow test strips that lack quantitative results or by high complexity immunoassays that are time- and labor-intensive but provide quantitative results. Here, we describe a novel application of biolayer interferometry for the rapid detection of antigen-specific antibody levels in plasma samples, and demonstrate its utility for quantification of SARS-CoV-2 antibodies. Our biolayer interferometry immunosorbent assay (BLI-ISA) utilizes single-use biosensors in an automated "dip-and-read" format, providing real-time optical measurements of antigen loading, plasma antibody binding, and antibody isotype detection. Complete quantitative results are obtained in less than 20 minutes. BLI-ISA meets or exceeds the performance of high complexity methods such as Enzyme-Linked Immunosorbent Assay (ELISA) and Chemiluminescent Immunoassay. Importantly, our method can be immediately implemented on existing BLI platforms for urgent COVID-19 studies, such as serosurveillance and the evaluation of vaccine candidates. In a broader sense, BLI-ISA can be developed as a novel diagnostic platform to evaluate antibodies and other biomolecules in clinical specimens.
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Affiliation(s)
- John V. Dzimianski
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, California, USA
| | - Nicholas Lorig-Roach
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, California, USA
| | - Sara M. O’Rourke
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, California, USA
| | | | - Jacqueline M. Kimmey
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, California, USA
| | - Rebecca M. DuBois
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, California, USA
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24
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Sullivan HC, Roback JD. Convalescent Plasma: Therapeutic Hope or Hopeless Strategy in the SARS-CoV-2 Pandemic. Transfus Med Rev 2020; 34:145-150. [PMID: 32359788 PMCID: PMC7179481 DOI: 10.1016/j.tmrv.2020.04.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 12/27/2022]
Abstract
As the world faces the current SARS-CoV-2 pandemic, extensive efforts have been applied to identify effective therapeutic agents. Convalescent plasma collected from recovered patients has been a therapeutic modality employed for over a hundred years for various infectious pathogens. Specifically, it has been used in the treatment of many viral infections with varying degrees of clinical efficacy. As we consider the use of convalescent plasma in the battle against this new strain of coronavirus, it is prudent to review what is known from past experiences. Accordingly, the aim of this review is to examine in detail studies of convalescent plasma used during previous viral outbreaks and pandemics with particular focus on hemorrhagic fevers, influenza, and other coronaviruses. The concluding sections of this review address the potential use of convalescent plasma during the present-day SARS-CoV-2 pandemic, not only insofar as its clinical benefit but also the steps required to make convalescent plasma treatments readily available for an exponentially growing patient population. By the end, the authors hope to address the extent to which convalescent plasma represents a realistic therapeutic approach, or a distraction from other potentially useful treatments.
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Affiliation(s)
- H Cliff Sullivan
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA.
| | - John D Roback
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
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Wieruszewski PM, Linn DD. Contemporary management of severe influenza disease in the intensive care unit. J Crit Care 2018; 48:48-55. [PMID: 30172033 PMCID: PMC7127549 DOI: 10.1016/j.jcrc.2018.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 01/12/2023]
Abstract
Despite continued efforts to optimize vaccination composition, severe influenza disease requiring intensive care unit (ICU) admission remains a clinical issue. Influenza epidemics and pandemics worldwide continue to challenge clinicians with managing infected patients requiring ICU care. While routine use of antiviral therapy is deployed in ambulatory outpatients, their use in the ICU in patients with hypoxemic respiratory failure is less well established. Additionally, these therapies primarily target the neuraminidase protein, while contemporary research is increasingly demonstrating potential therapeutic benefits of targeting the hemagglutinin protein. These data have given rise to a growing interest in the use of immune modulating therapies for treatment of severe influenza. Additionally, pandemic outbreaks have revealed the growing need for salvage management, wherein lies the potential role for venovenous extracorporeal membrane oxygenation therapy in refractory respiratory failure. In this report, we review the contemporary ICU care of the severe influenza patient. Influenza remains a challenging disease in the intensive care unit. Early anti-viral therapy may be associated with reduced mortality in the critically ill. Evidence surrounding the use of immune modulating therapies is growing. Corticosteroids are harmful and should not be used during the treatment of influenza. Additional research and commercial optimization is needed for widespread application of immune therapies.
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Affiliation(s)
- Patrick M Wieruszewski
- Department of Pharmacy, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
| | - Dustin D Linn
- Department of Pharmacy, Parkview Regional Medical Center, 11109 Parkview Plaza Drive, Fort Wayne, IN 46845, United States; Manchester University College of Pharmacy, Natural, & Health Sciences, 10627 Diebold Road, Fort Wayne, IN 46845, United States.
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The use of convalescent plasma to treat emerging infectious diseases: focus on Ebola virus disease. Curr Opin Hematol 2016; 22:521-6. [PMID: 26457963 DOI: 10.1097/moh.0000000000000191] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the use of convalescent plasma for the treatment of emerging infectious diseases, focusing on the recent use for the treatment of Ebola virus disease (EVD). RECENT FINDINGS Ebola convalescent plasma has been used as a therapy for treatment of EVD during the 2014 West Africa epidemic. Several cases from the United States and Europe have been recently published, in addition to multiple ongoing clinical trials in the United States and West Africa. Even more recently, convalescent plasma has been used for treatment of individuals with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. SUMMARY Although the first reports of successful treatment with passive immune therapy date back to the early 1900s, convalescent plasma has materialized as a possible therapy for patients who develop infection from one of the emerging infectious diseases such as EVD or MERS-CoV, although the efficacy of such therapy has yet to be proven in clinical trials.
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27
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Tian X, Jiang Z, Ma Q, Liu Q, Lu X, Liu W, Liao X, Zhou R, Su X, Luo Q. Prevalence of neutralizing antibodies to common respiratory viruses in intravenous immunoglobulin and in healthy donors in southern China. J Thorac Dis 2016; 8:803-12. [PMID: 27162653 DOI: 10.21037/jtd.2016.03.29] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute respiratory infections (ARIs) are a leading cause of death among children under the age of 5. However, there are no effective drugs for most of these severe viral infections. Passive immunotherapy with convalescent plasma or hyperimmune intravenous immunoglobulin (H-IVIG) is a potential therapeutic option for serious viral infections. It is important to find a suitable source of convalescent plasma and of H-IVIG containing high titer neutralizing antibodies (NAbs). METHODS Sera from 96 healthy adult donors in southern China and commercially available IVIG were analyzed for the titers of NAb to several most common respiratory viruses including respiratory syncytial virus (RSV), seasonal influenza A (InfA), enterovirus 71 (EV71), coxsackievirus A16 (CA16), adenovirus type 3 (Ad3) and a recent epidemic adenovirus type 55 (Ad55) by microneutralization test. RESULTS A high proportion of samples from healthy adult donors were positive for NAbs (>16) to all the viruses except Ad55. A different proportion of these samples had high NAb titers (>512) for InfA (25%), Ad3 (17.71%), RSV (9.38%), EV71 (1.04%), CA16 (3.13%), and Ad55 (4.17%). Commercially available IVIG had high NAb titers to InfA and Ad3 (>1,000) and lower NAb titers to RSV [320], EV71 [160], and CA16 [160]. Strikingly, IVIG also had a high NAb titer to Ad55 (>1,000). CONCLUSIONS Convalescent plasma could be screened from healthy blood volunteers to establish blood banks and to prepare specific H-IVIG for treating severe ARIs caused by common respiratory viruses.
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Affiliation(s)
- Xingui Tian
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Zaixue Jiang
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Qiang Ma
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Qian Liu
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Xiaomei Lu
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Wenkuan Liu
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Xiaohong Liao
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Rong Zhou
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Xiaobo Su
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
| | - Qingming Luo
- 1 Department of Medical Genetics and Cell Biology, School of Basic Science, Guangzhou Medical University, Guangzhou 511436, China ; 2 State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China ; 3 Dongguan Institute of Pediatrics, Dongguan Children's Hospital, Dongguan 523325, China
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Treatment-donation-stockpile dynamics in ebola convalescent blood transfusion therapy. J Theor Biol 2016; 392:53-61. [PMID: 26721704 PMCID: PMC7094096 DOI: 10.1016/j.jtbi.2015.11.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/11/2015] [Accepted: 11/20/2015] [Indexed: 11/25/2022]
Abstract
The interim guidance issued by the World Health Organization during the West Africa 2014 Ebola outbreak provides guidelines on the use of convalescent blood from Ebola survivors for transfusion therapy. Here we develop a novel mathematical model, based on the interim guidance, to examine the nonlinear transmission–treatment–donation–stockpile dynamics during an Ebola outbreak and with a large scale use of the transfusion therapy in the population. We estimate the reduction of case fatality ratio by introducing convalescent blood transfusion as a therapy, and inform optimal treatment–donation–stockpile strategies to balance the treatment need for case fatality ratio reduction and the strategic need of maintaining a minimal blood bank stockpile for other control priorities. A novel model for the large-scale use of the convalescent blood transfusion therapy. Based on WHO׳s interim convalescent treatment guidance in 2014 Ebola outbreak. Estimate the reduction of case fatality ratio by introducing convalescent therapy. Inform optimal treatment-donation-stockpile strategies. Guide convalescent blood transfusion services in future emerging disease outbreaks.
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Convalescent plasma: new evidence for an old therapeutic tool? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:152-7. [PMID: 26674811 DOI: 10.2450/2015.0131-15] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/23/2015] [Indexed: 02/08/2023]
Abstract
Passive immunisation for the prevention and treatment of human infectious diseases can be traced back to the 20(th) century. The recent Ebola virus outbreak in West Africa has turned the spotlight onto the possible use of convalescent whole blood and convalescent plasma in the treatment of infectious diseases because they are the only therapeutic strategy available in some cases, given the unavailability of vaccines, drugs or other specific treatments. Convalescent blood products could be a valid option in the treatment/prophylaxis of several infectious diseases both in association with other drugs/preventive measures and as the only therapy when a specific treatment is not available. However, there are still some issues to consider in determining the advisability of implementing a large-scale convalescent plasma transfusion programme.
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Abstract
The world is regularly exposed to emerging infections with the potential to burst into a pandemic. One possible way to treat patients, when no other treatment is yet developed, is passive immunization performed by transfusing blood, plasma or plasma immunoglobulin fractions obtained from convalescent donors who have recovered from the disease and have developed protective antibodies. The most recent on-going epidemic is caused by the Ebola virus, a filovirus responsible for Ebola virus disease, a severe, often lethal, hemorrhagic fever. Recently, the use of convalescent blood products was proposed by the WHO as one early option for treating patients with Ebola virus disease. This publication provides an overview of the various convalescent blood products and technological options that could theoretically be considered when there is a need to rely on this therapeutic approach. In countries without access to advanced blood-processing technologies, the choice may initially be restricted to convalescent whole blood or plasma. In technologically advanced countries, additional options for convalescent blood products are available, including virally inactivated plasma and fractionated immunoglobulins. The preparation of minipool immunoglobulins is also a realistic option to consider.
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Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Lim WS, Makki S, Rooney KD, Nguyen-Van-Tam JS, Beck CR. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis 2015; 211:80-90. [PMID: 25030060 PMCID: PMC4264590 DOI: 10.1093/infdis/jiu396] [Citation(s) in RCA: 666] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/09/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence. METHODS Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria, using a 3-stage process. Data extraction and risk of bias assessments were undertaken. RESULTS We identified 32 studies of SARS coronavirus infection and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy (odds ratio, 0.25; 95% confidence interval, .14-.45; I(2) = 0%). Studies were commonly of low or very low quality, lacked control groups, and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified. CONCLUSIONS Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of Middle East respiratory syndrome coronavirus CoV infection.
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Affiliation(s)
| | - Maria Saavedra-Campos
- Field Epidemiology Training Programme, Public Health England, London
- Field Epidemiology Service, Public Health England, Liverpool
| | | | - Paul Cleary
- Field Epidemiology Service, Public Health England, Liverpool
| | | | - Wei Shen Lim
- Respiratory Medicine, Nottingham University Hospitals NHS Trust
| | | | - Kevin D. Rooney
- Institute of Care and Practice Improvement, University of the West of Scotland, Hamilton, United Kingdom
| | | | | | - Charles R. Beck
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham
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Hohenadl C, Wodal W, Kerschbaum A, Fritz R, Howard MK, Farcet MR, Portsmouth D, McVey JK, Baker DA, Ehrlich HJ, Barrett PN, Kreil TR. Hyperimmune intravenous immunoglobulin containing high titers of pandemic H1N1 hemagglutinin and neuraminidase antibodies provides dose-dependent protection against lethal virus challenge in SCID mice. Virol J 2014; 11:70. [PMID: 24739285 PMCID: PMC3996311 DOI: 10.1186/1743-422x-11-70] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 04/07/2014] [Indexed: 12/29/2022] Open
Abstract
Background Convalescent plasma and fractionated immunoglobulins have been suggested as prophylactic or therapeutic interventions during an influenza pandemic. Findings Intravenous immunoglobulin (IVIG) preparations manufactured from human plasma collected before the 2009 H1N1 influenza pandemic, and post-pandemic hyperimmune (H)-IVIG preparations were characterized with respect to hemagglutination inhibition (HI), microneutralization (MN) and neuraminidase-inhibiting (NAi) antibody titers against pandemic H1N1 (pH1N1) and seasonal H1N1 (sH1N1) viruses. The protective efficacy of the IVIG and H-IVIG preparations was evaluated in a SCID mouse challenge model. Substantial levels of HI, MN and NAi antibodies against pH1N1 (GMTs 1:45, 1:204 and 1: 727, respectively) and sH1N1 (GMTs 1:688, 1:4,946 and 1:312, respectively) were present in pre-pandemic IVIG preparations. In post-pandemic H-IVIG preparations, HI, MN and NAi antibody GMTs against pH1N1 were 1:1,280, 1:11,404 and 1:2,488 (28-, 56- and 3.4-fold enriched), respectively, compared to pre-pandemic IVIG preparations (p < 0.001). Post-pandemic H-IVIG (HI titer 1:1,280) provided complete protection from lethality of SCID mice against pH1N1 challenge (100% of mice survived for 29 days post-challenge). Pre-pandemic IVIG (HI titer 1:70) did not provide significant protection against pH1N1 challenge (50% of mice survived 29 days post-challenge compared to 40% survival in the buffer control group). There was a highly significant correlation between circulating in vivo HI and MN antibody titers and survival (p < 0001). Conclusion The substantial enrichment of HA- and NA-specific antibodies in H-IVIG and the efficacious protection of SCID mice against challenge with pH1N1 suggests H-IVIG as a promising intervention against pandemic influenza for immunocompromised patients and other risk groups.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Thomas R Kreil
- Global Pathogen Safety, Baxter BioScience, Benatzkygasse 2-6, 1221 Vienna, Austria.
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Abstract
The pandemic H1N1 influenza that began in Mexico in the spring of 2009 spread rapidly to southern California within days and around the world within a few months. Because the genetic make-up of the new virus was novel, several months of lead-in time were required before a suitable vaccine for human use could be produced and distributed. The effort to confront the virus on the part of the World Health Organization which included almost every nation on earth and a vast array of scientists and public health officials was extensive and timely. However, it was the moderate severity of the virus itself that saved global public health from catastrophe. Because of the extensive publicity and research that occurred during the H1N1 pandemic, many lessons were learned that will be useful in confronting future influenza pandemics. A "One Health" approach to prevent, detect, and combat future pandemics is essential.
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Affiliation(s)
- Juergen A Richt
- Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, K-224B Mosier Hall, Manhattan, KS, 66506-5601, USA,
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The Pandemic H1N1 Influenza Experience. Curr Top Microbiol Immunol 2013. [DOI: 10.1007/978-3-662-45792-4_309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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35
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Cheng VCC, To KKW, Tse H, Hung IFN, Yuen KY. Two years after pandemic influenza A/2009/H1N1: what have we learned? Clin Microbiol Rev 2012; 25:223-63. [PMID: 22491771 PMCID: PMC3346300 DOI: 10.1128/cmr.05012-11] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The world had been anticipating another influenza pandemic since the last one in 1968. The pandemic influenza A H1N1 2009 virus (A/2009/H1N1) finally arrived, causing the first pandemic influenza of the new millennium, which has affected over 214 countries and caused over 18,449 deaths. Because of the persistent threat from the A/H5N1 virus since 1997 and the outbreak of the severe acute respiratory syndrome (SARS) coronavirus in 2003, medical and scientific communities have been more prepared in mindset and infrastructure. This preparedness has allowed for rapid and effective research on the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the disease, with impacts on its control. A PubMed search using the keywords "pandemic influenza virus H1N1 2009" yielded over 2,500 publications, which markedly exceeded the number published on previous pandemics. Only representative works with relevance to clinical microbiology and infectious diseases are reviewed in this article. A significant increase in the understanding of this virus and the disease within such a short amount of time has allowed for the timely development of diagnostic tests, treatments, and preventive measures. These findings could prove useful for future randomized controlled clinical trials and the epidemiological control of future pandemics.
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Affiliation(s)
- Vincent C C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
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Pourroy BNJ, Kolmos HJ, Nielsen LP. Antibody administration in experimental influenza increases survival and enhances the effect of oseltamivir. Health (London) 2012. [DOI: 10.4236/health.2012.430143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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