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Published on: July 17, 2014
Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy
Gustavo de Carvalho Duarte1, Vivian Simoni1, Glaciano Nogueira Ribeiro1
1HHemo, São Paulo, SP, Brazil.
Insights
Implementing a national Covid-19 Convalescent Plasma program is feasible in resource-limited settings. This study shows a successful program adapted for a middle-income economy, ensuring quality standards were met.
Area of Science:
- Immunology
- Transfusion Medicine
- Public Health
Background:
- Convalescent Plasma therapy was a key strategy for treating COVID-19.
- Implementing a national program presented significant challenges, especially in middle-income economies.
Purpose of the Study:
- To develop and implement a high-quality COVID-19 Convalescent Plasma Program.
- To adapt the program for resource-limited settings.
Main Methods:
- A multicentric program involved selective donor recruitment and antibody screening.
- Plasma was collected via apheresis or whole-blood processing.
- Distribution to hospitals was based on local demand.
Main Results:
- Only 47% of screened candidates were eligible for plasma donation.
- Higher antibody levels correlated with donor age (>45), prior hospital admission, and shorter intervals post-diagnosis.
- 61% of donations came from whole-blood processing, 39% from apheresis.
Conclusions:
- A national COVID-19 Convalescent Plasma program is feasible even in resource-scarce countries.
- Alternative, lower-cost strategies can be employed while adhering to regulations and quality standards.
Introduction:
Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy.
Objectives:
Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources.
Methods:
A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand.
Results:
From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p = 0.002), hospital admission (p = 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation.
Conclusion:
The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.
