Convalescent plasma therapy in COVID-19: Unravelling the data using the principles of antibody therapy

Arturo Casadevall, Michael J. Joyner, Liise Anne Pirofski, Jonathon W. Senefeld, Shmuel Shoham, David Sullivan, Nigel Paneth, Daniele Focosi

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: When the COVID-19 pandemic struck no specific therapies were available and many turned to COVID-19 convalescent plasma (CCP), a form of antibody therapy. The literature provides mixed evidence for CCP efficacy. Areas covered: PubMed was searched using the words COVID-19 and convalescent plasma and individual study designs were evaluated for adherence to the three principles of antibody therapy, i.e. that plasma 1) contain specific antibody; 2) have enough specific antibody to mediate a biological effect; and 3) be administered early in the course of disease. Using this approach, a diverse and seemingly contradictory collection of clinical findings was distilled into a consistent picture whereby CCP was effective when used according to the above principles of antibody therapy. In addition, CCP therapy in immunocompromised patients is useful at any time in the course of disease. Expert opinion: CCP is safe and effective when used appropriately. Today, most of humanity has some immunity to SARS-CoV-2 from vaccines and infection, which has lessened the need for CCP in the general population. However, COVID-19 in immunocompromised patients is a major therapeutic challenge, and with the deauthorization of all SARS-CoV-2-spike protein-directed monoclonal antibodies, CCP is the only antibody therapy available for this population.

Original languageEnglish (US)
Pages (from-to)381-395
Number of pages15
JournalExpert Review of Respiratory Medicine
Volume17
Issue number5
DOIs
StatePublished - 2023

Keywords

  • COVID-19
  • SARS-CoV-2
  • antibody
  • convalescent plasma
  • immune therapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health

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