Use of convalescent plasma in COVID-19 patients in China

To the Editor-As of 10:00 on 28 April 2020, there still remained 2,954,222 confirmed Coronavirus Disease 2019 (COVID-19) cases, according to data provided by WHO [1]. In the seventh edition treatment and diagnosis guideline of COVID-19 published by the National Health Commission on Mar 3, scientists have reached a consensus that the plasma of convalescent patients contains antibodies that the therapy so far has proved to be a safe and effective for critical symptoms, as well as patients with rapid onset of COVID-19 [2]. Donors must be recovered patients who are up to the standard for being discharged from hospital. During the SARS and Ebola epidemic, we also used the plasma of recovered people to treat infected patients [3], [4]. International Council for Commonality in Blood Banking Automation has fast-tracked the release of new product description codes for convalescent plasma of COVID-19 patients.

China has developed convalescent plasma to treat patients who are infected with the COVID-19 and epidemic begins to subside in China. The therapy aims to use the antibodies in the convalescent plasma to neutralize the presence of the virus in patients. The patients have shown improved clinical symptoms about 12 to 24 hours after they received convalescent plasma, with main inflammatory indexes decreased significantly and some key indexes such as blood oxygen saturation improving comprehensively. During the COVID-19 outbreak, China established dedicated expert task force both on the national and local levels respectively to analyze and improve the production and treatment of plasma therapy. There have been mature conditions for scale application of the therapy in China.

Clinical practice shows the convalescent plasma should be early infused to ensure a better therapeutic effect. The treatment effect of recovered plasma in the treatment of critical. There are some experiences worthy of our share in convalescent plasma collection and infusion. The peak value of IgG antibody produced in COVID-19 patients conforms to the general rule. COVID-19 patients with cytokine storm syndrome (CSS) could not donate plasma after recovery. Plasma donation won’t hurt the donor once he or she has been discharged from the hospital for 14 days. A convalescent patient had better donate plasma only once. Besides normal components and specific IgG antibodies, convalescent plasma contain no other pathogenic substances and components. Convalescent plasma was prepared into freeze-dried or concentrated blood products, which is convenient for management and application, especially responding to emergencies. The curative effect of convalescent plasma is closely related to the quality, dose, antibody titer and infusion time of the plasma. The recovery plasma dose was determined according to the patient's viral load. In order to reduce the adverse reaction of transfusion and improve the clinical curative effect, the patients should be given promethazine hydrochloride or dexamethasone before convalescent plasma infusion. When using recovery plasma to treat infected patients, we should adhere to the individualized treatment and avoid the adverse consequences caused by following the same pattern.

Transfusion therapy is an ancient and novel technique, Ozone autotransfusion therapy has been used in antiviral therapy for more than 20 years. Madrid Declaration on Ozone Therapy (2nd Edition), officially issued by International Scientific Committee of Ozone Therapy in 2015, gives a detailed description of antivirus ozone autotransfusion therapy [5]. Combined with COVID-19 pneumonia clinical characteristics, ozone autotransfusion therapy could increase blood oxygen saturation, improve tissue hypoxia and reduce incidence of multiple organ failure caused by CSS. Scientists are studying the feasibility of ozone autotransfusion therapy in COVID-19 pneumonia patients in China. According to incomplete statistics, there are no less than 1000 hospitals in China that have carried out this technology, the operation is simple and easy to master, and no serious adverse events related to this technology have been found. We successfully applied of the technique to therapy a COVID-19 patient in Hubei province, China.

Authors’ contributions

HKM gathered information and drafted the manuscript. ZM and ZZJ co-designed the study and helped writing the manuscript. All authors read and approved the final manuscript.

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None.

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Not applicable.

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Disclosure of interest

The authors declare that they have no competing interests.