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Convalescent plasma for pediatric patients with SARS-CoV-2-associated acute respiratory distress syndrome

Caroline Diorio1,2, Elizabeth M Anderson3, Kevin O McNerney1,2

  • 1Immune Dysregulation Frontier Program, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Pediatric Blood & Cancer
|September 5, 2020
PubMed

Insights

Convalescent plasma (CP) shows promise as a safe and potentially effective treatment for children with severe COVID-19 complications. Further pediatric trials are necessary to confirm its efficacy in treating this critical illness.

Area of Science:

  • Pediatric Critical Care Medicine
  • Infectious Diseases
  • Immunology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses life-threatening risks to children, with no proven therapies.
  • Convalescent plasma (CP) has shown potential benefits in adult SARS-CoV-2 patients, but carries theoretical risks.

Purpose of the Study:

  • To report the first use of CP in pediatric patients with life-threatening coronavirus disease 2019 (COVID-19).
  • To assess the safety and potential efficacy of CP in children with acute respiratory distress syndrome (ARDS).

Main Methods:

  • Infusion of CP in four pediatric patients with ARDS due to COVID-19.
  • Measurement of donor antibody levels and recipient antibody response before and after CP infusion.
  • Evaluation for antibody-dependent enhancement (ADE) and impact on endogenous antibody response.

Main Results:

  • CP infusion was safe in pediatric patients with severe COVID-19.
  • No instances of antibody-dependent enhancement (ADE) were observed.
  • CP did not suppress the patients' endogenous antibody responses.
  • CP demonstrated possible efficacy in treating severe pediatric COVID-19.

Conclusions:

  • Convalescent plasma is a safe therapeutic option for children with severe COVID-19.
  • CP may be efficacious in managing life-threatening complications like ARDS in pediatric patients.
  • Randomized controlled trials are essential to establish definitive efficacy and optimal use of CP in pediatric COVID-19.

Keywords:
COVID-19SARS-CoV-2convalescent plasmapediatrics

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