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Guidance on the Use of Convalescent Plasma to Treat Immunocompromised Patients With Coronavirus Disease 2019

Evan M Bloch1, Daniele Focosi2, Shmuel Shoham3

  • 1Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|February 5, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) offers a safe and effective treatment for immunocompromised patients. High-titer CCP is recommended for acute and protracted COVID-19, with dosage varying by clinical setting.

Area of Science:

  • Infectious Diseases
  • Transfusion Medicine
  • Virology

Background:

  • Immunocompromised (IC) patients face elevated risks of severe COVID-19, persistent infection, and mortality.
  • Despite clinical use, optimal dosing, scheduling, and duration for COVID-19 convalescent plasma (CCP) in IC patients remain undefined.
  • Current treatment guidelines for CCP in IC patients are lacking.

Purpose of the Study:

  • To provide an expert opinion statement on the use of CCP for treating COVID-19 in immunocompromised patients.
  • To address the need for best practices and optimal treatment parameters for CCP therapy in this vulnerable population.

Main Methods:

  • An expert panel convened, comprising specialists in infectious diseases, virology, and transfusion medicine.
  • The panel rendered an expert opinion statement based on current knowledge and clinical experience.

Main Results:

  • CCP is considered a safe and effective treatment for both acute and protracted COVID-19 in IC patients.
  • Recently and locally collected CCP, matched to circulating variants, is recommended for optimal efficacy.
  • High-titer CCP retains activity against SARS-CoV-2 variants, maintaining effectiveness where monoclonal antibodies have failed.

Conclusions:

  • CCP should be utilized for treating COVID-19 in immunocompromised individuals.
  • Dosage and treatment strategies for CCP should be tailored to the clinical presentation (acute vs. protracted COVID-19).
  • CCP represents a valuable therapeutic option, particularly against emerging SARS-CoV-2 variants.

Keywords:
antibodiesimmunocompromised hostpassive immunizationplasma

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