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Convalescent Plasma Treatment and Results in COVID-19 Infections

Year 2020, Volume: 3 Issue: S1, 68 - 77, 15.05.2020

Abstract

COVID-19 (coronavirus disease 2019) is a respiratory tract infection with a coronavirus thought to have originated as a zoonotic virus. In 2019, this outbreak began from Wuhan, China, causing a pandemia with a high mortality rate and medical and socioeconomic turmoil all over the world and with no proven treatment and vaccination. Clinical findings (commonly fever, cough, rarely headache, gastrointestinal symptoms; rhinorrhea, sneezing, sore throat are unusual) starting mildly, progress (in some cases) to the point of respiratory distress and shock. Mortality rate among is generally about 2% to 3% in severe cases. For patients with severe disease in ICU, drugs like Chloroquine and hydroxychloroquine, Remdesivir, Lopinavir-ritonavir, Tocilizumab and Sarilumab (Interleukin-6 antagonists for cytokine release syndrome), Corticosteroids, antibiotics for secondary infections, antifungals, antivirals, supportive treatment, anticoagulants, non-invasive or mechanical ventilations are being used; in addition to them, immune convalescent plasma from cured patients is being used recently. The efficacy of immune convalescent plasma for patients in ICU, might come from the suppression of viremia by antibodies; early usage may result with early immunity. Passive Antibody Treatment (immune convalescent plasma) is defined as transfer of antibodies from patients with activated immune system against this pathogen to severe patients for treatment or prophylaxis. Sufficient levels of neutrolizing antibodies in plasma and early treatment for patients with high risk factors are the key factors for the success of this treatment. Loss of these antibodies in time could not be proven in limited number of studies. For this specific treatment, the donors, and the experience of the center and staff is crucial. The donor, if treated inpatient, must have two negative molecular nasopharyngeal swab tests for SARS-CoV-2, at least 24 hours apart Their clinical findings (cough, fever, dyspnea, fatigue, etc) must have disappeared for at least 14 days. The rules for being a blood donor should also be checked. Males, women with no history of pregnancy and no transfusion in the past are preferable. Immune plasma donation might be applied for three times/month (7-10 days apart) starting from the initial donation. The convalescent plasma, must have >1:80 neutralizing antibody titers for anti-SARS-CoV-2 if possible. Until the test becomes possible, 200-600 ml of plasma should be collected by apheresis and pathogen inactivation and irradiation (30Gy) must be considered. FDA from USA prepared a guide for this procedure. According to this guide, this tratment must be given to severe COVID-19 patients with the following findings: laboratory proven COVID-19, severe (dyspnea, respiration rate ≥ 30/min, blood oxygen saturation ≤% 93, PAO2 / FIO2 <300, increasing lung infiltration >% 50 in 24-48 hours) or life threatening (respiratory failure, septic shock, multiorgan dysfunction or failure); informed concent is also needed. There are three main studies for the usage of immune convalescent plasma for COVID-19. These studies are with small number of patients, uncontrolled and together with standart therapies and antivirals. In all three studies, this treatment is well tolerated without any severe side effects. The results of these pilot studies showed that immune convalescent plasma might be a potential treatment for SARS-CoV-2 (+), critical patients. But, the effect of convalescent plasma on overall survival is still obscure as these patients are also getting supportive care, experimental drugs, antivirals and there were no control groups. So the clinical efficacy of immune convalescent plasma and/or supportive care could not be estimated clearly. The effect and safety of convalescent plasma transfusions for SARS-CoV-2 (+) patients must be tested with well designed, controlled studies with more patients.

References

  • 1. WHO: Coronavirus Disease 2019 (COVID-19): Situation Report--51. WHO website. Published March 11, 2020. Accessed April 6, 2020. https:// www.who.int/docs/default-source/ coronaviruse/situation-reports/20200311sitrep-51-covid-19.pdf 2.
  • 2. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses: The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44.
  • 3. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. 2020;395(10223):507-513.
  • 4. CDC: Coronavirus Disease 2019 (COVID-19) Situation Summary. CDC website. Updated March 26, 2020. Reviewed March 26, 2020. Accessed April 6, 2020. https://www.cdc.gov/ coronavirus/2019-ncov/cases-updates/summary. html
  • 5. WHO: Clinical Management of Severe Acute Respiratory Infection When Novel Coronavirus (nCoV) Infection Is Suspected: Interim Guidance. WHO website. Updated March 13, 2020. Accessed April 6, 2020. https://www.who.int/publicationsdetail/clinical-management-of-severe-acuterespiratoryinfection-when-novel-coronavirus(ncov)-infection-is-suspected
  • 6. Lu X, Zhang L, Du H et al: SARS-CoV-2 infection in children. N Engl J Med. 2020;382:1663-5
  • 7. Babiker A, Myers CW, Hill CE, et al. SARS-CoV-2 testing. Am J Clin Pathol 2020;XX:1-3 DOI: 10.1093/ajcp/aqaa052
  • 8. WHO: Global Surveillance for Human Infection With Coronavirus Disease (COVID-19): Interim Guidance. WHO website. Updated February 27, 2020. Accessed April 6, 2020. https://www.who. int/publications-detail/global-surveillance-forhuman-infection-with-novel-coronavirus-(2019ncov)
  • 9. WHO: Laboratory Testing Strategy Recommendations for COVID-19: Interim Guidance. Updated March 21, 2020. Accessed April 6, 2020. https://apps.who.int/iris/bitstream/ handle/10665/331509/WHO-COVID-19-lab_ testing-2020.1-eng.pdf
  • 10. Hinton DM: [Letter granting emergency use authorization for use of chloroquine phosphate or hydroxychloroquine sulfate supplied from the Strategic National Stockpile for treatment of coronavirus disease 2019.] FDA website. Published March 28, 2020. Accessed April 6, 2020. https://www.fda.gov/media/136534/download
  • 11. Alhazzani W, Møller MH, Arabi YM et al: Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med https://doi.org/10.1007/s00134-02006022-5
  • 12. Jin YH, Cai L, Cheng ZS et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4.
  • 13. Cao B, Wang Y, Wen D et al: A trial of lopinavirritonavir in adults hospitalized with severe Covid-19. N Engl J Med March 18, 2020:1-13. DOI: 10.1056/NEJMoa2001282 [Epub ahead of print]
  • 14. FDA: Investigational COVID-19 Convalescent Plasma--Emergency INDs. FDA website. Updated April 3, 2020. Accessed April 6, 2020. https:// www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ide-process-ber/investigationalcovid-19-convalescent-plasma-emergency-inds
  • 15. Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400. doi: 10.1016/S14733099(20)30141-9
  • 16. Casadevall, Arturo; Scharff, Matthew D. Serum therapy revisited: animal models of infection and development of passive antibody therapy. Antimicrob Agents Chemother.  1994 Aug;38(8):1695-702.
  • 17. Casadevall A, Dadachova E, Pirofski LA.. Passive antibody therapy for infectious diseases. Nat Rev Microbiol. 2004;2(9):695-703.
  • 18. Türkiye Bilimler Akademisi ,Covid-19 Pandemi Değerlendirme Raporu ,21.Nisan 2017 ISBN: 978605-2249-43-7, Ankara
  • 19. Yeh KM, Chiueh TS, Siu LK, Lin JC, Chan PK., et al. Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital. J Antimicrob Chemother. 2005;56(5):919-22.
  • 20. Zhang JS, Chen JT, Liu YX, et al. A serological survey on neutralizing antibody titer of SARS convalescent sera. J Med Virol. 2005;77(2):147-50.
  • 21. Wan Y, Shang J, Sun S, et al. Molecular mechanism for antibody-dependent enhancement of coronavirus entry. J Virol. 2020; 94(5). pii: e0201519. doi: 10.1128/JVI.02015-19
  • 22. Ulusal Kan ve Kan Bileşenleri Hazirlama, Kullanim ve Kalite Güvencesi Rehberi. Erişim 19 Nisan 2020. https://www.kanver.org/Upload/ Dosya/ulusal_kan_rehberi.pdf
  • 23. WHO Blood Regulators Network (BRN), “Interim position Paper on blood regulatory reponse to the evolving out-break of the 2019 novel coronavirus SARS-CoV-2.” erişim 19 Nisan 2020. https://www. who.int/bloodproducts/brn/2017_BRN_ PositionPaper_Convalescent Plasm 19 Nisan 2020.
  • 24. https://www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ideprocess-cber/investigationalcovid-19-convalescent-plasma-emergency-inds
  • 25. Council of Europe, European Committee on Blood Transfusion (CD-P-TS). 19th Edition of the Guide to the Preparation, Use and Quality Assurance of Blood Components. https://www. edqm.eu/en/bloodguide 12. Epstein, J., Burnouf, T. (On behalf of the ISBT Working Party on Global Blood Safety). Points to consider in the preparation and transfusion of COVID-19 convalescent plasma, erişim 19 nisan 2020.
  • 26. International Society of Blood Transfusion :Erişim 19.Nisan. 2020 http://isbtweb.org/fileadmin/ user_upload/Points_to_consider_in_the_ preparation_of_COVID_convalesc ent_ plasma_-_200331_ISBT_WP_GBS_Final.pdf
  • 27. American Association of Blood Banks , erişim 19 Nisan 2020. http://www.aabb.org/advocacy/ regulatorygovernment/ Documents/COVID-19Convalescent-Plasma-Collection.pdf
  • 28. T.C Sağlık Bakanlığı, https://covid19bilgi.saglik. gov.tr/depo/enfeksiyon-kontorl-onlemleri/ COVID19-PlazmaUygulamaRehberi.pdf erişim 20.Nisan.2020
  • 29. Duan, K., Liu, B., Li, C. et al. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study. March 23, 2020. https:// doi.org/ 10.1101/ 2020.03.16.20036145
  • 30. Shen, C., Wang, Z., Zhao, F. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783
  • 31. Zhang B, Liu S, Tan T, et al, Treatment with convalescent plasma for critically ill patients with SARS-CoV2 infection. Chest. 2020 Mar 31. pii: S0012-3692(20)30571-7. doi: 10.1016/j. chest.2020.03.039. [Epub ahead of print]
  • 32. FDA, “Investigational COVID-19 Convalescent Plasma Emergency INDs.”, erişim 25 Mart 2020. https://www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ide-process-cber/investigationalcovid-19- convalescent-plasma-emergency-ind

COVID-19 Enfeksiyonlarında İmmun Plazma Tedavisi ve Sonuçları

Year 2020, Volume: 3 Issue: S1, 68 - 77, 15.05.2020

Abstract

COVID-19 enfeksiyonu, solunum yollarını tutan SARS-CoV-2 (ağır akut solunum sendromuna yol açan coronavirus 2) olarak adlandırılan bir zoonotik virustan kaynaklanmaktadır; 2019 yılının sonlarında Çin’in Wuhan şehrinden başlayarak tüm dünyada büyük bir pandemiye yol açan, yüksek mortalite oranları nedeniyle medikal ve sosyoekonomik bir karmaşaya neden olan, tedavisi henüz çok çeşitlilik gösteren, aşı ile korunması olmayan bir hastalıktır. Klinik bulgular (en sık ateş ve öksürük, daha nadir miyalji ve yorgunluk; nadiren baş ağrısı ve gastro-intestinal semptomlar görülür; nezle ve boğaz ağrısı görülmez) hafif başlayıp RDS ve şoka gidebilir, genellikle ağır seyretmektedir ve total mortalite %2-3 civarındadır. Yoğun bakımdaki hastalarda, Klorokin, Remdesivir, Lopinavir-ritonavir, sitokin salınımı sendromu için Tocilizumab ve Sarilumab (İnterlökin-6 antagonistleri), Kortikosteroidler, sekonder infeksiyonlar için antibiotikler, antifungaller, destek tedaviler, antikoagülanlar, non-invazif veya mekanik ventilasyonlar kullanılmaktadır, buna ilave olarak hastalığı tamamen iyileşen kişilerden toplanan plazma ile yapılan immun plazma tedavisi de uygulanmaktadır. İmmun plazma tedavisinin etkinliği için olası bir açıklama, immun plazmadan alınan antikorların viremiyi baskılayabilmesidir, erken immunite gelişeceğinden hastalığın erken evresinde uygulanması daha etkili olmalıdır. Pasif Antikor Tedavisi (immun plazma tedavisi), söz konusu patojene karşı immun sistemi aktive olmuş bireylerden patojene karşı duyarlı bireylere tedavi veya profilaksi amacıyla antikorların aktarılması olarak tanımlanmaktadır. Bu tedavinin olumlu sonuçlanmasında en önemli etkenlerden birisi nakledilen plazmada yeterli miktarda nötralizan antikorun olması, bir diğeri ise yaş gibi potansiyel risk faktörlerinin olduğu bireylerin tedavisine hızlı başlanması şeklinde özetlenebilir. İyileşen hastaların plazmasında zamana bağlı antikorların azalabileceği konusunda sınırlı çalışmalarda bu düşüş gözlenmemiştir. Özellikli bir tedavi olduğundan verici, ortam, işlemi yapacak merkezin ve personelin yeterliliği önemlidir. Bağışçı adayı, hastanede yatarak tedavi görmüş bir kişi ise en az 24 saat ara ile iki nazofarenks sürüntü örneğinin SARS-CoV-2 moleküler test sonuçları “NEGATİF” bulunmalı ve klinik olarak (öksürük, ateş, nefes darlığı, halsizlik vb.) iyileşmesinin üzerinden en az 14 gün geçmiş olmalıdır. Gönüllü COVID-19 immün plazma bağışçısı olabilmek için “Tam Kan Bağışı” için gereken şartların mevcut olması gereklidir. İmmün plazma bağışçıları tercihen erkeklerden, gebe kalmamış (doğum/düşük/kürtaj) kadınlardan ve kan transfüzyonu yapılmamış kişilerden seçilmelidir. İmmün plazma bağışı, ilk bağışın yapıldığı tarih başlangıç tarihi olarak kabul edilmek kaydıyla, en az 7-10 günde bir olmak üzere bir ay içerisinde en fazla 3 kez yapılabilir. Plazmalardan, anti-SARS-CoV-2 titreleri nötralizan antikor değeri 1:80 ve üzerinde olanların seçilmesi, bu test yapılabilir hale gelene kadar, bu ölçüm yapılmadan 200-600 ml plazmanın aferezle alınması, patojen inaktivasyonu ve 30Gy ışınlanması önerilmektedir. Amerikan İlaç ve Gıda Dairesi (FDA), halk sağlığı acil durumu sırasında COVID-19'dan (COVID-19 immun plazma) iyileşen bireylerden toplanan incelenen immun plazmanın yönetimi ve araştırılması konusunda sağlık hizmeti sağlayıcılarına ve araştırmacılara öneriler sunmak için bir rehber yayınlamıştır. Buna göre Covid-19 immun plazma adayı hasta uygunluk kriterleri şunları içerir: Laboratuvar onaylı COVID-19, şiddetli (nefes darlığı (dispne), solunum frekansı ≥ 30 / dak, kan oksijen saturasyonu ≤% 93, PAO2 / FIO2 <300, 24 ila 48 saat içinde akciğer infiltratları >%50) veya hemen hayatı tehdit eden COVID-19 enfeksiyonu (solunum yetmezliği, septik şok, çoklu organ disfonksiyonu veya yetersizliği) varlığı, hasta veya sağlık vekili tarafından bilgilendirilmiş onam alınması. Literatürde kovid-19 immun plazmanın kullanımı ile ilgili üç çalışma vardır. Bu çalışmalar, kontrolsuz küçük vaka serilerinden oluşmaktadır ve eş zamanlı tüm hastalara diğer standart bakımlar ve anti viral ilaçlar verilmiştir. Ayrıca her üç çalışmada da tedavi iyi tolere edilmiş ve ciddi bir immun plazma ilişkili yan etki gelişmemiştir. Pilot çalışma sonuçları, immun plazmanın SARS-CoV-2 ile enfekte olan kritik hastalar için potansiyel bir tedavi olabileceğini göstermektedir. Bununla birlikte, hastaların eş zamanlı destekleyici bakım, araştırma tedavileri, antiviral ilaçlar da almaları ve çalışmalarda kontrol grubunun olmaması nedeni ile verilen immun plazmanın sağkalım üzerine katkıları net değildir. İmmun plazma ve / veya destekleyici bakımın herhangi bir klinik yarar sağlayıp sağlamadığı bu nedenle tam olarak bilinmemektedir. SARS-CoV-2 ile enfekte olan hastalarda iyileşmiş plazma transfüzyonunun güvenliği ve etkinliği iyi tasarlanmış, kontrollü, geniş vaka sayısı içeren klinik çalışmalar bağlamında incelenmelidir.

References

  • 1. WHO: Coronavirus Disease 2019 (COVID-19): Situation Report--51. WHO website. Published March 11, 2020. Accessed April 6, 2020. https:// www.who.int/docs/default-source/ coronaviruse/situation-reports/20200311sitrep-51-covid-19.pdf 2.
  • 2. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses: The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44.
  • 3. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. 2020;395(10223):507-513.
  • 4. CDC: Coronavirus Disease 2019 (COVID-19) Situation Summary. CDC website. Updated March 26, 2020. Reviewed March 26, 2020. Accessed April 6, 2020. https://www.cdc.gov/ coronavirus/2019-ncov/cases-updates/summary. html
  • 5. WHO: Clinical Management of Severe Acute Respiratory Infection When Novel Coronavirus (nCoV) Infection Is Suspected: Interim Guidance. WHO website. Updated March 13, 2020. Accessed April 6, 2020. https://www.who.int/publicationsdetail/clinical-management-of-severe-acuterespiratoryinfection-when-novel-coronavirus(ncov)-infection-is-suspected
  • 6. Lu X, Zhang L, Du H et al: SARS-CoV-2 infection in children. N Engl J Med. 2020;382:1663-5
  • 7. Babiker A, Myers CW, Hill CE, et al. SARS-CoV-2 testing. Am J Clin Pathol 2020;XX:1-3 DOI: 10.1093/ajcp/aqaa052
  • 8. WHO: Global Surveillance for Human Infection With Coronavirus Disease (COVID-19): Interim Guidance. WHO website. Updated February 27, 2020. Accessed April 6, 2020. https://www.who. int/publications-detail/global-surveillance-forhuman-infection-with-novel-coronavirus-(2019ncov)
  • 9. WHO: Laboratory Testing Strategy Recommendations for COVID-19: Interim Guidance. Updated March 21, 2020. Accessed April 6, 2020. https://apps.who.int/iris/bitstream/ handle/10665/331509/WHO-COVID-19-lab_ testing-2020.1-eng.pdf
  • 10. Hinton DM: [Letter granting emergency use authorization for use of chloroquine phosphate or hydroxychloroquine sulfate supplied from the Strategic National Stockpile for treatment of coronavirus disease 2019.] FDA website. Published March 28, 2020. Accessed April 6, 2020. https://www.fda.gov/media/136534/download
  • 11. Alhazzani W, Møller MH, Arabi YM et al: Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med https://doi.org/10.1007/s00134-02006022-5
  • 12. Jin YH, Cai L, Cheng ZS et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4.
  • 13. Cao B, Wang Y, Wen D et al: A trial of lopinavirritonavir in adults hospitalized with severe Covid-19. N Engl J Med March 18, 2020:1-13. DOI: 10.1056/NEJMoa2001282 [Epub ahead of print]
  • 14. FDA: Investigational COVID-19 Convalescent Plasma--Emergency INDs. FDA website. Updated April 3, 2020. Accessed April 6, 2020. https:// www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ide-process-ber/investigationalcovid-19-convalescent-plasma-emergency-inds
  • 15. Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400. doi: 10.1016/S14733099(20)30141-9
  • 16. Casadevall, Arturo; Scharff, Matthew D. Serum therapy revisited: animal models of infection and development of passive antibody therapy. Antimicrob Agents Chemother.  1994 Aug;38(8):1695-702.
  • 17. Casadevall A, Dadachova E, Pirofski LA.. Passive antibody therapy for infectious diseases. Nat Rev Microbiol. 2004;2(9):695-703.
  • 18. Türkiye Bilimler Akademisi ,Covid-19 Pandemi Değerlendirme Raporu ,21.Nisan 2017 ISBN: 978605-2249-43-7, Ankara
  • 19. Yeh KM, Chiueh TS, Siu LK, Lin JC, Chan PK., et al. Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital. J Antimicrob Chemother. 2005;56(5):919-22.
  • 20. Zhang JS, Chen JT, Liu YX, et al. A serological survey on neutralizing antibody titer of SARS convalescent sera. J Med Virol. 2005;77(2):147-50.
  • 21. Wan Y, Shang J, Sun S, et al. Molecular mechanism for antibody-dependent enhancement of coronavirus entry. J Virol. 2020; 94(5). pii: e0201519. doi: 10.1128/JVI.02015-19
  • 22. Ulusal Kan ve Kan Bileşenleri Hazirlama, Kullanim ve Kalite Güvencesi Rehberi. Erişim 19 Nisan 2020. https://www.kanver.org/Upload/ Dosya/ulusal_kan_rehberi.pdf
  • 23. WHO Blood Regulators Network (BRN), “Interim position Paper on blood regulatory reponse to the evolving out-break of the 2019 novel coronavirus SARS-CoV-2.” erişim 19 Nisan 2020. https://www. who.int/bloodproducts/brn/2017_BRN_ PositionPaper_Convalescent Plasm 19 Nisan 2020.
  • 24. https://www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ideprocess-cber/investigationalcovid-19-convalescent-plasma-emergency-inds
  • 25. Council of Europe, European Committee on Blood Transfusion (CD-P-TS). 19th Edition of the Guide to the Preparation, Use and Quality Assurance of Blood Components. https://www. edqm.eu/en/bloodguide 12. Epstein, J., Burnouf, T. (On behalf of the ISBT Working Party on Global Blood Safety). Points to consider in the preparation and transfusion of COVID-19 convalescent plasma, erişim 19 nisan 2020.
  • 26. International Society of Blood Transfusion :Erişim 19.Nisan. 2020 http://isbtweb.org/fileadmin/ user_upload/Points_to_consider_in_the_ preparation_of_COVID_convalesc ent_ plasma_-_200331_ISBT_WP_GBS_Final.pdf
  • 27. American Association of Blood Banks , erişim 19 Nisan 2020. http://www.aabb.org/advocacy/ regulatorygovernment/ Documents/COVID-19Convalescent-Plasma-Collection.pdf
  • 28. T.C Sağlık Bakanlığı, https://covid19bilgi.saglik. gov.tr/depo/enfeksiyon-kontorl-onlemleri/ COVID19-PlazmaUygulamaRehberi.pdf erişim 20.Nisan.2020
  • 29. Duan, K., Liu, B., Li, C. et al. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study. March 23, 2020. https:// doi.org/ 10.1101/ 2020.03.16.20036145
  • 30. Shen, C., Wang, Z., Zhao, F. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783
  • 31. Zhang B, Liu S, Tan T, et al, Treatment with convalescent plasma for critically ill patients with SARS-CoV2 infection. Chest. 2020 Mar 31. pii: S0012-3692(20)30571-7. doi: 10.1016/j. chest.2020.03.039. [Epub ahead of print]
  • 32. FDA, “Investigational COVID-19 Convalescent Plasma Emergency INDs.”, erişim 25 Mart 2020. https://www.fda.gov/vaccines-blood-biologics/ investigational-new-drug-ind-or-deviceexemption-ide-process-cber/investigationalcovid-19- convalescent-plasma-emergency-ind
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Dentistry, Pharmacology and Pharmaceutical Sciences, Toxicology, Clinical Sciences
Journal Section Review
Authors

Hüseyin Saffet Beköz This is me 0000-0003-1237-8281

Hülya Bilgen This is me 0000-0002-7424-8688

Seniye Sema Anak This is me 0000-0001-8489-7449

Publication Date May 15, 2020
Submission Date April 24, 2020
Published in Issue Year 2020 Volume: 3 Issue: S1

Cite

MLA Beköz, Hüseyin Saffet et al. “COVID-19 Enfeksiyonlarında İmmun Plazma Tedavisi Ve Sonuçları”. Sağlık Bilimlerinde İleri Araştırmalar Dergisi, vol. 3, no. S1, 2020, pp. 68-77.