BALTIMORE (April 7, 2020) — Nearly a month into the COVID-19 pandemic, neither preventative treatment for people exposed to SARS-CoV-2, the coronavirus that triggers the disease, nor therapy for those who go on to contract the disease itself exists.
Now, a team of researchers led by Johns Hopkins Medicine has pioneered a workflow for the deployment of convalescent plasma, which it projects to be a safe, effective therapy for COVID-19 patients.
The guidance was published online Tuesday in the Journal of Clinical Investigation.
“We’ve received many inquiries from health care providers looking to ramp up their ability to deliver this therapy,” says lead author Evan Bloch, M.D., associate professor of pathology at the Johns Hopkins University School of Medicine.
Patients recovering from COVID-19, called convalescents, develop antibodies in their blood plasma that may be donated through a transfusion. This process is also referred to as passive antibody therapy. The researchers analyzed its global use throughout the last century, particularly during the SARS1 and MERS outbreaks in 2003 and 2012, respectively.
Figure 1: Convalescent plasma collections workflow. (J Clin Invest. 2020;130(6):2757-2765. https://doi.org/10.1172/JCI138745)
“There is historical precedent for its use to prevent and treat viral illness,” Bloch says.
The team also reviewed Chinese studies in which convalescent plasma was given to COVID-19 patients. Despite a small sample size of 15 severely and critically ill patients between the two studies, each patient demonstrated improved clinical status following therapy. The researchers recognize the need for larger, randomized studies, but conclude these data indicate convalescent plasma is a promising, safe way to reduce viral load.
As convalescent plasma can be harnessed and dispensed via established blood collection and transfusion procedures already in place around the world, the team developed a step-by-step guide for its use to treat the newest coronavirus. The workflow addresses:
Donor eligibility and recruitment
Pre-donation screening
Antibody testing
Blood collection and testing
Distribution of convalescent plasma
Optimal dosing and transfusion.
“This paper details the nuts and bolts of how to deploy convalescent plasma, and this information should be very helpful to colleagues worldwide who are preparing to use this therapy against COVID-19,” says Arturo Casadevall, M.D., Ph.D., chair of the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health who also teaches at the School of Medicine.
Bloch, Casadevall and colleagues further detailed future research necessary to strengthen the case for convalescent plasma’s efficacy in treating COVID-19. This includes testing adults in close contact with an individual who has COVID-19, patients with varying severity of the disease, as well as children who are at high risk of infection.
“During the chaos of an epidemic, the therapy is often deployed without rigorously studying its effects,” Bloch says. “Carefully conducted studies are critically needed to understand which people are most likely to benefit from this therapy and how best to apply it to optimize that benefit.”
This research was supported in part by grant number 1K23HL151826 from the National Institutes of Health to Bloch, who is also a member of the FDA Blood Products Advisory Committee.
Bloch and Casadevall are available for interviews.
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This press release was written for Lindsey Leake’s 491.750 Contemporary Science and Medical Writing: Creative and Professional Forms course at the Johns Hopkins University Krieger School of Arts and Sciences on Feb. 21, 2021.