USE OF CONVALESANT PLASMA IN COVID-19 INFECTION

Öz

Coronavirus 2 (SARS-CoV-2), which started in December 2019 in Wuhan province in China and caused serious respiratory infections in humans, was accepted as a pandemic on March 11, 2020. The disease from SARS-CoV-2 is called COVID-19. In a short period of five months, approximately 4 million people were infected and 300 thousand people died from this disease. To date, no specific therapeutic agents or prophylaxis for COVID-19 are available, so it is among the passive immunization treatment options with the plasma of patients who recover from the disease. Convalescent plasma therapy has been used in epidemic periods in the past and has been shown to be effective. Neutralizing antibodies in plasma contributes to recovery by inactivating the virus. In the literature, there are 4 publications presenting a total of 21 patients receiving convalescent plasma. They reported that the patients benefited from the treatment of convalescent plasma and that there were no complications. Studies have been initiated about convalescent plasma all over the world and their results are interestedly awaited.

Anahtar Kelimeler

• Konvalesan plasma
• İmmün plazma
• COVID-19
• SARS-CoV-2

COVID-19 ENFEKSİYONUNDA KONVALESAN (İMMÜN) PLAZMA KULLANIMI

Öz

Çin’de Wuhan eyaletinde Aralık 2019’da başlayan ve insanlarda ciddi solunum yolu enfeksiyonlarına neden olan Coronavirus 2 (SARS-CoV-2) çok hızlı bir yayılım göstererek 11 Mart 2020 tarihinde pandemi olarak kabul edilmiştir.  SARS-CoV-2 kaynaklı hastalık tablosuna COVID-19 adı verilmektedir. Beş ay gibi kısa bir sürede yaklaşık 4 milyon kişi enfekte olmuş ve 300 bin kişi bu hastalıktan kaybedilmiştir. Günümüze kadar etkili bir profilaksi ve tedavisi bulunamayan hastalıkta iyileşen hastaların plazması ile pasif bağışıklama tedavi seçenekleri arasında bulunmaktadır. Konvalesan plazma tedavisi geçmişte salgın hastalık dönemlerinde kullanılmış, etkili olduğu gösterilmiştir. Plazmadaki nötralizan antikorlar virüsü inaktive ederek iyileşmeye katkı sağlamaktadır. Literatürde, konvalesan plazma verilen toplam 21  hastanın sunulduğu 4 yayın bulunmaktadır. Hastaların konvalesan plazma tedavisinden fayda gördüklerini ve herhangi bir komplikasyon olmadığını bildirmişlerdir. Tüm dünyada konvalesan plazmayla ilgili başlatılmış çalışmalar olup bunların sonuçları merakla beklenmektedir.

Anahtar Kelimeler

• Convalescent plasma
• COVID-19
• Immune plasma
• SARS-CoV-2

Kaynakça

1. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41:145-51
2. Yin S, Peng Y, Ren Y, et al. The implications of preliminary screening and diagnosis: Clinical characteristics of 33 mild patients with SARS-CoV-2 infection in Hunan, China. J J Clin Virol. 2020;128:104397.
3. Gasparyan AY, Misra DP, Yessirkepov M, et al. Perspectives of Immune Therapy in Coronavirus Disease 2019. J Korean Med Sci. 2020;18:e176.
4. Rojas M, Rodriguez Y, Monsalve DM, et al. Convalescent plasma in Covid-19: Possible mechanisms of action. Autoimmun Rev.. 2020:102554.
5. Thevarajan I, Nguyen THO, Koutsakos M, et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med. 2020;26:453-455.
6. Casadevall A, Pirofski LA. The convalescent sera option for containing COVID-19. T J Clin Invest. 2020;130:1545-1548.
7. Duan, K., Liu, B., Li, C. et al. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study.BMJ. 2020;3:16.20036145
8. Investigational covid-19 convalescent plasma—emergency INDs. https://www.fda. gov/ vaccines-blood-biologics/investigational-newdrug-ind-or-device-exemption-ideprocesscber/ investigational-covid19-convalescent-plasma-emergency-inds

9. WHO. Rolling updates on corona virüs disease (COVID-19). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen. Updated March 17, 2020 Accessed March 18, 2020.
10. Turkish Ministry of Health Immune Plasma Guidelines, 2020. Available from: URL: https://dosyamerkez.saglik.gov.tr/Eklenti/37163,covid-19-immun-plazma-rehberi-12-nisan-2020-sonv1-ti-neopdfpdf.pdf?0&_tag1= D61DB6867EF68EE9A7FE73C870D9BBA04AACC05C
11. McGonagle D, Sharif K, O'Regan A, et al. The Role of Cytokines including Interleukin-6 in COVID-19 induced Pneumonia and Macrophage Activation Syndrome-Like Disease. Autoimmunity rev. 2020;3:102537.
12. COVID-19 and Convalescent Plasma: Frequently Asked Questions, ASH Webinar on the Use of Convalescent Plasma During COVID-19, hematology.zoom.us/webinar/register/WN_iSKRIhdeSPe8YEuu0C37Vg 13. 8 May, 2020.
13. Zhang B, Liu S, Tan T, et al. Treatment With Convalescent Plasma for Critically Ill Patients With SARS-CoV-2 Infection. Chest. 2020; pii: S0012-3692(20)30571-7.
14. Liu BP, Chong EY, Cheung FW, Duan JA, Che CT, Liu WK. Tangutorine induces p21 expression and abnormal mitosis in human colon cancer HT-29 cells. Biochem Pharmacol. 2005;70:287-99.
15. Shen C, Wang Z, Zhao F, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. 2020
16. Ahn JY, Sohn Y, Lee SH, et al. Use of Convalescent Plasma Therapy in Two COVID-19 Patients with Acute Respiratory Distress Syndrome in Korea. J Korean Med Sci. 2020 ;35:e149