[ad_1]
At the end of Monday, the World Health Organization (WHO) advised not to treat COVID-19 with convalescent plasma.
“WHO does not recommend its use in non-severe COVID-19 patients, but it should only be used in clinical trials in severe and severe COVID-19 patients,” WHO said.
Convalescent plasma therapy uses the plasma of patients who have recovered from COVID-19 to prevent the progression of the disease and help others who are actively ill with the disease to help recover faster. Includes treatment.
Antibodies in the plasma of recovered COVID-19 patients were thought to have the potential to provide passive immunity to sick patients by neutralizing the SARS-CoV-2 virus.
“Despite the original promise, current evidence shows that: [convalescent plasma therapy] It does not improve survival or reduce the need for ventilators, and administration is costly and time consuming, “the British Medical Journal (BMJ) said in a late Monday press release.
Based on 16 randomized controlled trials
The new recommendations were published at the BMJ and developed by the WHO Guideline Development Group (GDG), an international panel of scientists. Severe and serious COVID-19.
“The included RCTs have registered non-pregnant females and males,” GDG said. Said in a medical journal.. “There was no reason to think that GDG would react differently to treatment with convalescent plasma in children and pregnant women with covid-19, so GDG speculates that children and pregnant women should not be intervened either. Did.”
The group said, “There was no benefit to any of the significant or significant consequences of non-severe covid-19” after receiving convalescent plasma therapy. I didn’t see the legitimacy.) It would be related to the administration of plasma during the convalescent period. “
In addition, “GDG should not use convalescent plasma as part of routine care in the severity subgroup, but not enough severe and severe patients to justify the continuation of the RCT. I believed there was certainty, “he added.
“Although not shown in the summary of evidence, it can always be harmful to transfusions of blood products,” said a committee of scientists.
Patients with severe or severe COVID-19 should receive both corticosteroids and IL-6 receptor blockers. Recommended by GDG. In some cases, the panel states that severe or critical COVID-19 may be treated with neutralizing monoclonal antibodies.
Previous paper
Several previous studies have suggested that COVID-19 convalescent plasma therapy is ineffective in reducing disease progression and sometimes in reducing mortality, but recent 23 RTCs. Meta-analyses have found some benefit in reducing the risk of death.
In August, a large randomized placebo-controlled trial was funded. National Institute of Health It was found that administration of convalescent plasma to high-risk outpatients within one week of the onset of symptoms “could not prevent the progression of the disease.”
The results of this study (Covid-19 convalescent plasma (C3PO) study in outpatients) are: New England Journal of Medicine, 511 patients were enrolled. The progression of COVID-19 disease occurred in about 30% of both groups, with 5 patients in the plasma group and 1 patient in the placebo group dying, the study authors reported.
The authors write that the trial was discontinued in February due to lack of efficacy. Clifton Callaway, the study’s lead researcher, said the researchers said the treatment would “reduce disease progression by at least 10% … but instead we observed a reduction of less than 2%. I was expecting it. “
Separately, in a UK study of patients admitted with COVID-19, Recovery trial Published in May — the authors discovered that “the risk of death after administration of high titer plasma was no different from standard treatment”. 11,558 patients participated in this study.
Another study, Published in Nature Medicine In September, it was discovered that convalescent plasma did not reduce the risk of intubation or death. However, researchers have found that changes in the antibody content of convalescent plasma may have altered the response to treatment.
But lately 23 RTC meta-analysis Researchers, published in September, analyzed variables that affect the efficacy of convalescent plasma in the study, and while data on clinical efficacy were mixed, convalescent plasma showed mortality in many studies. I found that I lowered it. This paper has not been peer-reviewed yet and has been published as a preprint.
“Focusing on only the 23 RTC results available, plasma neutralizing titers of 160 and above and randomization time of 9 days or less are consistent with passive antibodies and reduce mortality. It was found that it is likely to show a signal of efficacy, such as. A therapeutic effect that requires the administration of sufficient antibodies, “the authors write.
“The fact that most studies reveal a signal of efficacy despite variability [COVID-19 convalescent plasma] And its use suggests a powerful therapeutic effect that is evident despite the data noise, “the author added.
The authors also stated that some of the studies they reviewed “reported overall negative results.” [regarding convalescent plasma therapy] … Despite the presence of positive signals of efficacy, little statistical significance is lost. “
FDA Emergency Use Authorization
Convalescent plasma therapy approved by the US Food and Drug Administration (FDA) For emergency use Treat COVID-19 in August 2020.
Federal Regulatory Authority Narrowed the scope of EUA In February, we will only allow plasma containing high levels of antibodies (called “high titer recovery plasma”) and COVID-19 patients who were hospitalized before respiratory failure or had weakened immunity. ..
“Plasma with a narrow range of antibodies has not proven useful in COVID-19,” the FDA said in a revised EUA at the time. It was communicated to the healthcare provider in a fact sheet (pdf), “Based on the overall scientific evidence available at this time, the known and potential benefits of high titer COVID-19 convalescent plasma are when administered in the early stages of the disease, and in humoral disorders. Outweighs the known and potential risks of hospitalization. Immunity. “
Dr. Paul Malik, a professor of medicine at the Eastern Virginia Medical University and director of the Department of Pulmonary Emergency Medicine, who has treated patients with COVID-19 since the start of the pandemic, said that the Epoch Times’ convalescent plasma had previously made patients with “severe immunodeficiency”. It’s effective.
Associate Professor Schmuelshoham of Johns Hopkins University, Told endpoint news At the end of Monday, convalescent plasma therapy to treat COVID-19 is “effective and generally safe” “when used at a sufficiently high titer at the right time”.
The American Red Cross has stopped collecting convalescent plasma from recovered COVID-19 patients since June 2021 due to low hospital demand and sufficient storage in the blood industry. ..
Meiling Lee contributed to this report.
follow
Mimi Nguyen Ly is an Australian-based assignment editor and world news reporter. She has a background in optometry. Contact her at [email protected].
[ad_2]