Passive Antibody Therapy Against COVID-19 Holds Some Promise
Klaus Mergener, MD, PhD, FASGE, reviewing Shen C, et al. JAMA 2020 March 27.
In this very small case series of 5 critically ill patients with COVID-19 and respiratory failure due to acute respiratory distress syndrome, individuals received convalescent plasma with high titers of neutralizing antibodies against SARS-CoV-2, obtained from patients who had recovered from the same illness. Plasma was administered in a single transfusion between hospital days 10 and 22. One week after transfusion, the clinical status of all 5 patients had improved significantly, as evidenced by normalization of body temperature and improvement in respiration parameters and the radiographic appearance of pneumonia.
COMMENT
The general principle of using convalescent plasma in the management of viral illnesses is well understood and has been applied in a variety of infections, including influenza A (H1N1), SARS, and Ebola.The current report comes with the usual significant limitations of a nonrandomized small-scale case series. Patients received concomitant therapies, for example, with antiviral medications and steroids, and they may have improved spontaneously without the administration of plasma. Many related questions, such as optimal timing and number of infusions, remain to be answered.
Still, this represents encouraging evidence of a potentially viable therapeutic option for patients with severe COVID-19. If confirmed in more rigorous clinical trials, this strategy provides some hope at a point in time when other specific therapies and a vaccine to treat and prevent COVID-19 are still sorely lacking.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Klaus Mergener, MD, PhD, FASGE
CITATION(S)
Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA 2020 March 27. (Epub ahead of print) (https://doi.org/10.1001/jama.2020.4783)
