[Skip to Content]
[Skip to Content Landing]

Convalescent Plasma to Treat COVID-19Possibilities and Challenges

Educational Objective
To understand the challenges and need for RCTs on convalescent plasma
1 Credit CME

In this issue of JAMA, Shen et al report findings from a preliminary study of 5 severely ill patients with coronavirus disease 2019 (COVID-19) who were treated in the Shenzhen Third People's Hospital, China, using plasma from recovered individuals.1 All patients had severe respiratory failure and were receiving mechanical ventilation; 1 needed extracorporeal membrane oxygenation (ECMO) and 2 had bacterial and/or fungal pneumonia. Four patients without coexisting diseases received convalescent plasma around hospital day 20, and a patient with hypertension and mitral valve insufficiency received the plasma transfusion at day 10. The donor plasma had demonstrable IgG and IgM anti–SARS-CoV-19 antibodies and neutralized the virus in in vitro cultures. Although these patients continued to receive antiviral treatment primarily with lopinavir/ritonavir and interferon, the use of convalescent plasma may have contributed to their recovery because the clinical status of all patients had improvement approximately 1 week after transfusion, as evidenced by normalization of body temperature as well as improvements in Sequential Organ Failure Assessment scores and Pao2/Fio2 ratio. In addition, the patients’ neutralizing antibody titers increased and respiratory samples tested negative for SARS-CoV-2 between 1 and 12 days after transfusion.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Jeannette Guarner, MD, Emory Medical Laboratories, Emory University Hospital-Midtown Core Laboratory, Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322 (jguarne@emory.edu).

Published Online: March 27, 2020. doi:10.1001/jama.2020.4940

Conflict of Interest Disclosures: Dr Roback reports being a member of the American Red Cross Biomedical Services Medical Advisory Council; a consultant to CSL Plasma; a consultant to Secure Transfusion Services; and a cofounder, stockholder, and consultant to Cambium Medical Technologies. Dr Guarner reports no disclosures.

References
1.
Shen  C , Wang  Z , Zhao  F ,  et al.  Treatment of 5 critically ill patients with COVID-19 with convalescent plasma.   JAMA... Published online March 27, 2020 doi:10.1001/jama.2020.4783Google Scholar
2.
Cheng  Y , Wong  R , Soo  YO ,  et al.  Use of convalescent plasma therapy in SARS patients in Hong Kong.   Eur J Clin Microbiol Infect Dis. 2005;24(1):44-46. doi:10.1007/s10096-004-1271-9PubMedGoogle ScholarCrossref
3.
Leider  JP , Brunker  PA , Ness  PM .  Convalescent transfusion for pandemic influenza: preparing blood banks for a new plasma product?   Transfusion. 2010;50(6):1384-1398. doi:10.1111/j.1537-2995.2010.02590.xPubMedGoogle ScholarCrossref
4.
Casadevall  A , Pirofski  LA .  The convalescent sera option for containing COVID-19.   J Clin Invest. 2020;138003. doi:10.1172/JCI138003PubMedGoogle Scholar
5.
Kraft  CS , Hewlett  AL , Koepsell  S ,  et al; Nebraska Biocontainment Unit and the Emory Serious Communicable Diseases Unit.  The Use of TKM-100802 and Convalescent Plasma in 2 Patients With Ebola Virus Disease in the United States.   Clin Infect Dis. 2015;61(4):496-502. doi:10.1093/cid/civ334PubMedGoogle ScholarCrossref
6.
Dean  CL , Hooper  JW , Dye  JM ,  et al.  Characterization of Ebola convalescent plasma donor immune response and psoralen treated plasma in the United States.   Transfusion. 2020. doi:10.1111/trf.15739PubMedGoogle Scholar
7.
Tabor  E .  The epidemiology of virus transmission by plasma derivatives: clinical studies verifying the lack of transmission of hepatitis B and C viruses and HIV type 1.   Transfusion. 1999;39(11-12):1160-1168. doi:10.1046/j.1537-2995.1999.39111160.xPubMedGoogle ScholarCrossref
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close