Convalescent plasma pag

Among the various treatment proposals for COVID-19 infection passive immunotherapy using plasma from recovering patients could be a promising option in the treatment of SARS-CoV-2 infections.

Riccardo Cecchinato, IIIC

oronavirus disease 2019 (COVID-19), caused by the novel coronavirus, remains a global health crisis with limited treatment options. Among the various treatment proposals for COVID-19 infection (as the use of antiviral agent Remdesivir), passive immunotherapy using plasma from recovering patients- “convalescent plasma” (CP)- could be a promising option in the treatment of SARS-CoV-2 infections, waiting SARS-Cov-2 vaccine to be tested and safely deployed.

munotherapy mean. Immunotherapy modes can be divided into two types: passive and active. The active type strengthens the immune system’s response to various pathogenic attacks by activating both humoral immunity and cell-mediated immunity (1), using the adaptive response; active immunotherapy can also be artificial (vaccine). Passive antibody therapy involves transfusing the acellular portion of blood (plasma) from individuals who have recovered from an infection to persons who are infected. Plasma donors are presumed to have developed an effective antibody response to the offending pathogen; the conferred immunity is short term. Passive immunotherapy can prevent the clinical development of the infection or reduce the severity of the infection in those subjects recently exposed to various pathogens.

(1) La risposta immunitaria si divide in umorale (humoral immunity) e cellulare (cell-mediated immunity). Quella umorale è mediata dai linfociti B che, legati ad un antigene di una cellula estranea al corpo, danno il via alla creazione delle plasmacellule (che creeranno gli anticorpi che si legano alla superficie di antigeni) e delle cellule della memoria. Quella cellulare è diretta contro qualsiasi fattore che alteri una

cellula normale (riconosciuta per gli antigeni esposti grazie alle proteine HLA), e viene messa in atto dai linfociti T; questa risposta è fondamentale, per esempio, nel riconoscimento delle cellule tumorali. History. Since the early 20th century convalescent blood products and their antibody derivatives have been used for the treatment and prevention of infectious diseases; for example in 1918 H1N1 influenza pandemic(2) found a significant reduction in mortality associated with CP use. Last time that plasma was employed was during Ebola virus epidemic in 2015; previously it was also used during Sars-CoV-1 in 2002.

(2) H1N1 influenza pandemic= pandemia di influenza spagnola che tra il 1918 e 1920 uccise decine di milioni di persone Use of cp during covid. According to the World Health Organization, the use of plasma therapy is permitted when faced with «serious diseases for which there are no effective pharmacological treatments». Several clinical trials are underway to test the effectiveness of hyperimmune plasma at various stages of SARS-CoV2; for example at the University Hospital of Grenoble, or at Mantova’s Hospital. Moreover Mayo Clinic published a preprint that reports that the timing of plasma transfusions in a cohort of 35,322 patients was associated with much lower mortality; it’s important to note that the EAP(3) is not a clinical trial. In the USA, the Food and Drug Administration (FDA) has approved the use of CP for compassionate use (3) in the treatment of patients with a critical COVID-19 infection. The risks are very low: blood has been used to treat many other conditions and it’s very safe. Candidates for hyperimmune plasma donation are individuals with documented SARS-CoV-2 infection who voluntarily adhere to plasma apheresis donation. They must meet the following eligibility criteria: -age between 18 and 60 years old -weight not -50 kg -people that tested positive to nasopharyngeal swab and now are negative to COVID-19 -people that showed symptoms (fever, cold, anosmia, pneumonia)

(3) compassionate use= possibilità di somministrare a pazienti in condizioni critiche, a fini terapeutici, medicinali o terapie per i quali non è stata completata la fase di sperimentazione. Conclusions. Convalescent plasma is a possible weapon against Sars-Cov-2, in fact different clinical trials suggest that it may lessen the severity or shorten the duration of COVID-19. Further thorough studies are needed to test its safety and

efficacy to make the best use on an appropriate patient target.

plasma in Padua. If you are in favour of convalescent plasma donation and you want to have some explanation, please call the blood center which is closest to your house from the following in the province of Padua(4).

(4) I centri di raccolta della provincia di Padova sono • Ospedale di Schiavonia-Monselice: tel.0429/715333-5336 dalle 8.00 alle 13.30 • Ospedale di Piove di Sacco: tel.049/9718342 dalle 8.00 alle 13.30 • Ospedale di Camposampiero: tel.049/9324852 dalle ore 10 alle ore 15 • Ospedale di Cittadella: tel. 049/9424877 dalle ore 10 alle ore 15 • Centro Raccolta Sangue Padova - via dei Colli: tel. 3386598918 dalle ore 9 alle 14

1. Towards characterized convalescent plasma for COVID-19, The Lancet [https://www.thelancet.com/action/show Pdf?pii=S2589-5370%2820%2930289-3] 2. Vaccines, convalescent plasma, and monoclonal antibodies for covid-19, BMJ, British Medical Journal [https://www.bmj.com/content/370/bmj .m272] 3. Effect of Convalescent Plasma on Mortality among Hospitalized Patients with COVID-19: Initial Three-Month Experience, Mayo Clinic [https://www.medrxiv.org/content/10.11 01/2020.08.12.20169359v1] 4. Dalla spagnola al coronavirus: storia della cura con il plasma iperimmune, Intervista al Professor di Storia della Medicina Zampieri dell’Università di Padova [https://www.dctv.unipd.it/dalla-spagnol a-al-coronavirus-storia-dellacura-con-il-plasma-iperimmune] 5. Anti-SARS-CoV-2 hyperimmune plasma workflow, Elsevier [https://www.ncbi.nlm.nih.gov/pmc/arti cles/PMC7283061/#sec0075title]