Production and use of convalescent plasma in COVID-19 treatment, taking into account the experience in the Central Millitary Hospital Prague
Abstract
One of the available treatment alternatives for COVID-19 is the administration of convalescent plasma (CP), blood plasma obtained from people who have undergone the disease. Administration of anti-SARS-CoV-2 antibodies in plasma is a method of passive specific immunization with an expected therapeutic response.
CP can also be used for production a specific immunoglobulin. Experience from previous epidemic infections, caused by the coronaviruses SARS-CoV-1 and MERS-CoV, shows that CP contains neutralizing antibodies against the virus, which are probably the main source of its therapeutic potential.
However, other immune mechanisms cannot be ruled out, such as antibody-induced cellular cytotoxicity and/or phagocytosis. The use of CP for the treatment of COVID-19 spread during the first half of year 2020 in many countries worldwide and relatively common is also in the Czech Republic, where, at the end of August 2020, about 100 patients were treated with CP.
The production and use of CP is governed by the national multidisciplinary guidelines from April 2020 and the recommended therapeutic dose are 2 TU RP (400-450 mL), resp. 4-6 mL/kg. CP is indicated mainly in severe cases of COVID-19, which require oxygen support, ideally within 2-3 days after diagnosis, but our and foreign experience shows a beneficial effect of CP even in moderately severe cases that do not need oxygen treatment.