Perplexing issues for convalescent immune plasma therapy in COVID-19

Area of Science:

• Immunology
• Infectious Diseases
• Virology

Background:

• Convalescent immune plasma (CIP) therapy is a recognized treatment for coronavirus disease 2019 (COVID-19).
• The precise mechanisms of CIP action in COVID-19 are not fully understood, but viral neutralization is a primary proposed mechanism.
• CIP has demonstrated beneficial effects and safety in treating severe infectious diseases.

Purpose of the Study:

• To review the current understanding and application of Convalescent Immune Plasma (CIP) therapy for COVID-19.
• To discuss the potential role and mechanisms of CIP in managing viral infections.

Main Methods:

• Review of existing literature, systematic reviews, and meta-analyses on CIP transfusions in severe infectious diseases.
• Analysis of proposed mechanisms of action, including viral neutralization.
• Examination of dosage, administration protocols, and safety data for CIP therapy.

Main Results:

• CIP therapy is considered a trendy treatment option for COVID-19, approved under emergency use by the FDA.
• Viral neutralization is the presumed primary mechanism of action for CIP.
• CIP transfusions have shown beneficial effects and are generally safe, with no serious adverse events reported.
• Recommended antibody titers for SARS-CoV-2 in CIP are ideally above 1:320, with lower thresholds also potentially effective.
• Standard dosage involves one unit (200 mL) per transfusion, with a maximum of three units (600 mL) administered.

Conclusions:

• Convalescent immune plasma (CIP) therapy plays a significant role in managing COVID-19 and other viral infections.
• CIP is a safe and effective therapeutic option, particularly when specific vaccines or treatments are unavailable.
• Further research into CIP's mechanisms and optimal use is warranted for various systemic and viral diseases.