PT  - JOURNAL ARTICLE
AU  - Simon R. Mucha
AU  - NurJehan Quraishy
TI  - Convalescent plasma for COVID-19
AID  - 10.3949/ccjm.87a.ccc056
DP  - 2020 Aug 05
TA  - Cleveland Clinic Journal of Medicine
4099  - http://www.ccjm.org/content/early/2020/07/29/ccjm.87a.ccc056.short
4100  - http://www.ccjm.org/content/early/2020/07/29/ccjm.87a.ccc056.full
AB  - Convalescent plasma has been used for over a century to treat various infections. Given the lack of currently available effective treatment for COVID-19, it has re-emerged as a potential therapeutic option. A direct antiviral effect of virus-neutralizing antibodies in convalescent plasma is believed to be main mechanism of action, but indirect effects may also contribute to improved viral clearance, inflammation, and organ function. While convalescent plasma therapy is proven safe and historical evidence suggests it may be effective, it has not been proven to be of benefit in acute COVID-19. Many clinical trials are currently underway to evaluate convalescent plasma for treatment of COVID-19, but the vast majority of plasma is currently administered as compassionate use of an experimental therapy through an expanded access program. While promising, convalescent plasma remains experimental and is not proven effective. In addition to its unproven efficacy, many questions remain regarding the accuracy and predictive value of antibody testing of donors and patients, optimal donor selection, and optimal timing and selection of patient most likely to benefit. Until these questions are answered, convalescent plasma should ideally be used in the context of well-designed clinical trials.