Clinical use of Convalescent Plasma in the COVID-19 pandemic: a transfusion-focussed gap analysis with recommendations for future research priorities

• Type of Material: Article
• Authors: Arwa Z Al-Riyami, Sultan Qaboos University Hospital, Oman; Richard Schafer, Goethe University Hospital; Karin van den Berg, South African Natl Blood Serv; Evan M Bloch, Johns Hopkins University; Lise J Estcourt, University of Oxford; Ruchika Goel, Johns Hopkins University Hospitals; Salwa Hindawi, King Abdulaziz University; Cassandra Josephson, Emory University; Kevin Land, Corporate Medical Affairs, Vitalant; Zoe K McQuilten, Monash University; Steven L Spitalnik, Columbia University; Erica M Wood, Monash University; Dana Devine, Canadian Blood Services; Cynthia So-Osman, Sanquin Blood Supply Foundation, Amsterdam
• Language: English
• Date: 2021-01-01
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/vox.12973
• Title of Journal or Parent Work: VOX SANGUINIS
• Volume: 116
• Issue: 1
• Start Page: 88
• End Page: 98
• Grant/Funding Information: Evan M. Bloch effort is supported in part by the National Heart Lung and Blood Institute (1K23HL151826‐01).
• Keywords: SARS-CoV-2; gap analysis; COVID-19; Science & Technology; Hematology; Life Sciences & Biomedicine; patient outcome; convalescent plasma
• Research Categories: Health Sciences, Pathology; Biology, Cell; Health Sciences, Public Health

Abstract

Background and objectives: Use of convalescent plasma for coronavirus disease 2019 (COVID-19) treatment has gained interest worldwide. However, there is lack of evidence on its dosing, safety and effectiveness. Until data from clinical studies are available to provide solid evidence for worldwide applicable guidelines, there is a need to provide guidance to the transfusion community and researchers on this emergent therapeutic option. This paper aims to identify existing key gaps in current knowledge in the clinical application of COVID-19 convalescent plasma (CCP). Materials and methods: The International Society of Blood Transfusion (ISBT) initiated a multidisciplinary working group with worldwide representation from all six continents with the aim of reviewing existing practices on CCP use from donor, product and patient perspectives. A subgroup of clinical transfusion professionals was formed to draft a document for CCP clinical application to identify the gaps in knowledge in existing literature. Results: Gaps in knowledge were identified in the following main domains: study design, patient eligibility, CCP dose, frequency and timing of CCP administration, parameters to assess response to CCP treatment and long-term outcome, adverse events and CCP application in less-resourced countries as well as in paediatrics and neonates. Conclusion: This paper outlines a framework of gaps in the knowledge of clinical deployment of CPP that were identified as being most relevant. Studies to address the identified gaps are required to provide better evidence on the effectiveness and safety of CCP use.