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Convalescent plasma treatment for COVID-19: Tempering expectations with the influenza experience.
European Journal of Immunology ( IF 4.5 ) Pub Date : 2020-09-04 , DOI: 10.1002/eji.202048723 Kanta Subbarao 1, 2 , Francesca Mordant 2 , Rajeev Rudraraju 2
European Journal of Immunology ( IF 4.5 ) Pub Date : 2020-09-04 , DOI: 10.1002/eji.202048723 Kanta Subbarao 1, 2 , Francesca Mordant 2 , Rajeev Rudraraju 2
Affiliation
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The COVID‐19 pandemic caused by the zoonotic coronavirus, SARS‐CoV‐2 has swept the world in 5 months. A proportion of cases develop severe respiratory tract infections progressing to acute respiratory distress syndrome and a diverse set of complications involving different organ systems. Faced with a lack of coronavirus‐specific antiviral drugs and vaccines, hundreds of clinical trials have been undertaken to evaluate repurposed drugs. Convalescent plasma from recovered patients is an attractive option because antibodies can have direct or indirect antiviral activity and immunotherapy works well in principle, in animal models, and in anecdotal reports. However, the benefits of convalescent plasma treatment can only be clearly established through carefully designed randomized clinical trials. The experience from investigations of convalescent plasma products for severe influenza offers a cautionary tale. Despite promising pilot studies, large multicenter randomized controlled trials failed to show a benefit of convalescent plasma or hyperimmune intravenous globulin for the treatment of severe influenza A virus infection. These studies provide important lessons that should inform the planning of adequately powered randomized controlled trials to evaluate the promise of convalescent plasma therapy in COVID‐19 patients.
中文翻译：
针对COVID-19的恢复期血浆治疗：流感经验令人期待。
由人畜共患型冠状病毒SARS-CoV-2引起的COVID-19大流行在5个月内席卷全球。一部分病例发展为严重的呼吸道感染，发展为急性呼吸窘迫综合征和涉及不同器官系统的多种并发症。面对缺乏冠状病毒特异性抗病毒药物和疫苗的情况，已进行了数百项临床试验来评估重新用途的药物。康复患者的恢复期血浆是一种有吸引力的选择，因为抗体可以具有直接或间接的抗病毒活性，并且免疫治疗原则上在动物模型和轶事报告中效果很好。但是，只有通过精心设计的随机临床试验才能清楚地确定恢复期血浆治疗的益处。对严重流感恢复期血浆产品的调查经验提供了一个警示性的故事。尽管有前瞻性的前瞻性研究，但大型多中心随机对照试验未能证明恢复性血浆或超免疫性静脉球蛋白可用于治疗严重的A型流感病毒感染。这些研究提供了重要的经验教训，这些经验教训应该为充分有力的随机对照试验的规划提供参考，以评估COVID-19患者恢复血浆治疗的前景。
更新日期：2020-10-05
中文翻译：
针对COVID-19的恢复期血浆治疗：流感经验令人期待。
由人畜共患型冠状病毒SARS-CoV-2引起的COVID-19大流行在5个月内席卷全球。一部分病例发展为严重的呼吸道感染，发展为急性呼吸窘迫综合征和涉及不同器官系统的多种并发症。面对缺乏冠状病毒特异性抗病毒药物和疫苗的情况，已进行了数百项临床试验来评估重新用途的药物。康复患者的恢复期血浆是一种有吸引力的选择，因为抗体可以具有直接或间接的抗病毒活性，并且免疫治疗原则上在动物模型和轶事报告中效果很好。但是，只有通过精心设计的随机临床试验才能清楚地确定恢复期血浆治疗的益处。对严重流感恢复期血浆产品的调查经验提供了一个警示性的故事。尽管有前瞻性的前瞻性研究，但大型多中心随机对照试验未能证明恢复性血浆或超免疫性静脉球蛋白可用于治疗严重的A型流感病毒感染。这些研究提供了重要的经验教训，这些经验教训应该为充分有力的随机对照试验的规划提供参考，以评估COVID-19患者恢复血浆治疗的前景。
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