Table 1.
Summary of the guidelines on the CCP use in COVID-19 immunocompromised patients.
| Guideline | Issuance | Indication | Strength of Recommendation | Certainty of Evidence | Reference |
|---|---|---|---|---|---|
| AABB | 09/2022 | Hospitalized: suggested use with standard care. | weak | low | [24] |
| Outpatients (immunocompromised or not): suggested use with standard care. | weak | low | |||
| NIH | 12/2022 | There is insufficient evidence for the panel to recommend either for or against the use of high-titer CCP for the treatment of COVID-19 in hospitalized or nonhospitalized patients who are immunocompromised. o Some Panel members would use CCP to treat an immunocompromised patient with significant symptoms attributable to COVID-19 and with signs of active SARS-CoV-2 replication and who is having an inadequate response to available therapies. In these cases, clinicians should attempt to obtain high-titer CCP from a vaccinated donor who recently recovered from COVID-19 likely caused by a SARS-CoV-2 variant similar to the variant causing the patient’s illness. |
- | - | [25] |
| FDA | 12/2021 | COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies is authorized for the treatment of COVID-19 in patients with immunosuppressive disease or receiving immunosuppressive treatment, in inpatient or outpatient settings. | - | - | [26] |
| IDSA | 3/2/2022 | Recommendation 14: Among ambulatory patients with mild-to-moderate COVID-19 at high risk for progression to severe disease who have no other treatment options*, the IDSA guideline panel suggests FDA-qualified high-titer CCP within 8 days of symptom onset. | weak | low | [27] |
| ECIL-9 | 9/17/2021 | Mild COVID-19: high-titer CCP is recommended in hematological patients within 72 h from symptom onset and anti-SARS-CoV-2 monoclonal antibodies not available. | weak | moderate | [28] |
| Moderate COVID-19: CCP is recommended in seronegative hematological patients. | moderate | low | |||
| NCCN (CCP obtained from subjects recovered from Omicron and previously vaccinated is preferred) | 8/19/2022 | Hospitalized COVID-19 cancer patients: consider high-titer CCP in immunocompromised patients, particularly those with B-cell impairment, and when anti-SARS-CoV-2 monoclonal antibodies are not available. | 2A 1 | - | [29] |
| COVID-19 cancer outpatients: high-titer CCP may be beneficial in immunocompromised patients, particularly those with B-cell impairment, with persistent SARS-CoV-2 infection. | 2A 1 | - |
1 Category 2A: based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate.