Perplexing issues for convalescent immune plasma therapy in COVID-19

Convalescent immune plasma (CIP) therapy in coronavirus disease 2019 (COVID-19) is presently a trendy choice of treatment. On March 24, 2020, the United States Food and Drug Administration approved of CIP treatment for seriously ill COVID-19 patients as an emergency investigational new drug. The precise mechanisms of action for CIP in COVID-19 have not yet been undoubtedly recognized. However, earlier research demonstrated that the main mechanism of CIP such as in other viral infections is viral neutralization. Systematic reviews and meta-analyses of the CIP transfusion in severe infectious diseases have shown that CIP has some beneficial effects and it is a harmless process to cure infectious diseases early after symptom beginning. It is suggested that SARS-CoV-2 neutralizing antibody titers in CIP should be ideally higher than 1: 320, but lower thresholds could also be useful. The suggested minimum dose for one individual is one unit (200 mL) of CIP. The second unit can be given 48 h succeeding the end of the transfusion of the first unit of CIP. Moreover, CIP can be applied up to a maximum of three units (600 mL). CIP could be administered in other systemic diseases, viral infections coincidentally associated with SARS-CoV-2 infection, as well as other therapeutic approaches for COVID-19. There are generally no serious adverse events described from CIP transfusion in these recipients. CIP may have a significant role as one of the therapeutic modalities for various viral infections when enough vaccines or other specific therapeutic agents are not on hand.

COVID-19’da Konvelans Ýmmün Plazma Tedavisi Ýçin Çeliþkili Meseleler

Konvelans immün plazma (KÝP) tedavisi COVID-19 hastalýðýnda günümüzde popüler bir tercihtir. 24 Mart 2020’de Amerikan Gýda ve Ýlaç Dairesi (FDA) þiddetli hastalýðý olan COVID-19 vakalarýnda KÝP tedavisini acil deneysel yeni bir ilaç olarak onaylamýþtýr. KÝP tedavisinin etki mekanizmasý kesin olarak açýklanamamýþtýr. Bununla beraber, diðer viral enfeksiyonlardaki önceki araþtýrmalar ana mekanizmasýnýn viral nötralizasyon olduðunu göstermiþtir. Aðýr enfeksiyon hastalýklarýndaki KÝP transfüzyonuyla ilgili yapýlan sistematik derleme ve metaanalizler KÝP’in bazý yararlarý olduðunu göstermiþtir, enfeksiyon hastalýklarýnýn tedavisinde semptomlarýn baþlamasýndan sonra erken kullanýlanýldýðýnda zararsýz bir iþlemdir. KÝP tedavisinde SARS-CoV-2 nötralizan antikor titresinin tercihen 1: 320 üstünde olmasý düþünülür fakat daha düþük seviyeler de faydalýdýr. Bir kiþi için önerilen KÝP minimum dozu bir ünitedir (200 ml). KÝP maksimum dozu altý ünitedir (600 ml). KÝP, SARS-CoV-2 enfeksiyonu ile beraberindeki diðer viral enfeksiyon, sistemik hastalýklar ve COVID-19 için diðer terapötik yaklaþýmlarla beraber uygulanabilir. Genel olarak, KÝP transfüzyonu alanlarda ciddi yan etki bildirilmemiþtir. Yeterli aþý ve diðer spesifik tedavi ajanlarýnýn bulunmadýðý durumlarda, deðiþik viral enfeksiyonlarýn tedavi seçeneklerinden biri olarak önemli role sahiptir. (NCI-2021-3-2)