The world is challenged with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic. Although preventive measures such as social distancing, personal protective equipment and isolation would decrease the spread of the infection, a definitive treatment is still under way. Antivirals, immunisation, convalescent plasma (CP) and many more modalities are under trial, and there has been no definite answer to the management of COVID-19 infection. All patients so far have received the standard and symptomatic care. It is shown that the SARS-CoV 2 is a respiratory pathogen, and 80% of the infected patients would recover from the illness and it is the 20% of the infected patients require hospitalisation and even critical care. CP has been used to treat recent epidemic respiratory infections such as Middle East respiratory syndrome and severe acute respiratory syndrome (SARS) infections with promising results. The CP of a recovered individual contains antibodies which neutralise the virus and decrease the viral replication in the patient. It is a classic adaptive immunotherapy and has been applied in the prevention and treatment of many infectious diseases. CP is plasma taken from a person who has recovered from an infection, which contains neutralising antibodies against the said infection. Giving CP to susceptible individuals or infected patients is a form of passive antibody therapy and in the case of SARS-CoV-2, is expected to provide protection by viral neutralisation and antibody-dependent cytotoxicity and phagocytosis. The adaptive response is to a specific antigen-binding array of molecules that are foreign to the host. The human response to viruses uses both the innate and the adaptive arms in its attempt to rid the host of the invading pathogen. The humoral response is a component of the adaptive immune response that allows for antibodies to bind to foreign invading pathogens, marks the pathogens and their toxins for phagocytosis and recruits further phagocytic cells to the site via the activation of the complement system and eventually prevents the pathogen from infecting target cells. Studies from Wuhan from various institutions during the research on COVID-19 infections during December 2019 have also shown promising results. Till date, randomised controlled studies for the use of CP in SARS-CoV-2 infection are lacking, and many countries have invited institutions to participate in clinical trials. The Indian Council of Medical research and the Central Drugs Standard Control Organisation, Government of India, have allowed the use of CP as an investigational drug under a trial basis. Internationally, agencies such as the USFDA, American Association of Blood Banks, European Blood Safety and British Blood Transfusion Society have also come out with various guidelines for the use of CP in COVID-19 infection. This article will review the current guidelines for the use of CP and compare the various guidelines of different agencies.


中文翻译：

---

恢复期血浆 – 对治疗 SARS Co-V2 感染有用吗？



世界面临严重急性呼吸综合征-冠状病毒 2 (SARS-CoV-2) 大流行的挑战。尽管社交距离、个人防护装备和隔离等预防措施可以减少感染的传播，但最终的治疗仍在进行中。抗病毒药物、免疫接种、恢复期血浆 (CP) 和许多其他方法正在试验中，并且对于 COVID-19 感染的管理还没有明确的答案。到目前为止，所有患者均已接受标准的对症治疗。研究表明，SARS-CoV 2是一种呼吸道病原体，80%的感染患者会康复，其中20%的感染患者需要住院治疗甚至重症监护。 CP已用于治疗最近流行的呼吸道感染，例如中东呼吸综合征和严重急性呼吸综合征（SARS）感染，并取得了良好的效果。康复者的 CP 含有中和病毒并减少患者体内病毒复制的抗体。它是经典的适应性免疫疗法，已应用于多种感染性疾病的预防和治疗。 CP 是从感染康复者身上提取的血浆，其中含有针对所述感染的中和抗体。向易感个体或感染患者提供 CP 是被动抗体疗法的一种形式，对于 SARS-CoV-2，预计可通过病毒中和以及抗体依赖性细胞毒性和吞噬作用提供保护。适应性反应是针对宿主外来的特定抗原结合分子阵列。人类对病毒的反应同时使用先天性和适应性武器来试图清除宿主的入侵病原体。 体液反应是适应性免疫反应的一个组成部分，它允许抗体与外来入侵病原体结合，标记病原体及其毒素以进行吞噬，并通过补体系统的激活将更多的吞噬细胞招募到该位点，最终阻止病原体以免感染靶细胞。 2019 年 12 月期间，来自武汉的多个机构对 COVID-19 感染的研究也显示出可喜的结果。迄今为止，缺乏使用CP治疗SARS-CoV-2感染的随机对照研究，许多国家已邀请机构参与临床试验。印度医学研究委员会和印度政府中央药物标准控制组织已允许在试验基础上使用 CP 作为研究药物。国际上，美国FDA、美国血库协会、欧洲血液安全和英国输血协会等机构也针对CP在COVID-19感染中的使用制定了各种指南。本文将回顾当前CP的使用指南并比较不同机构的各种指南。