Convalescent plasma as possible therapy against COVID-19
Emil von Behring discovered serum therapy. In 1901, he received the noble prize award for his work use in the treatment serum diphtheria antitoxin.16 By that time, he was widely known as a savior of children, because as diphtheria was the major cause of child death. Scientific studies indicated that SARS-CoV-2 (COVID-19) has a genome size of ~30 kilobases, like other coronaviruses, encodes for multiple structural and non-structural proteins. The structural proteins include the spike (S) protein, the envelope (E) protein, the membrane (M) protein, and the nucleocapsid (N) protein. A set of B cell and T cell epitopes derived from the spike (S) and nucleocapsid (N) proteins were identified this might be helpful for effective antibody production and vaccine design against COVID-19.17 SARS-CoV-2 and SARS-CoV-1 shared a common human host-cell receptor protein, angiotensin converting enzyme 2 (ACE2).18 In 2009, intensive care unit recruited H1N1 influenza virus infected patients shown that after treatment with convalescent plasma reduced respiratory tract viral load, serum cytokine response, and mortality.19 The convalescent serum plasma therapy experience of its efficacy and safety usage was reported from previously outbake of Middle East respiratory syndrome coronavirus (MERS-CoV).20 The convalescent plasma therapy has been used for the treatment SARS-CoV-1 patients in 2003 at Hong Kong which reported as good outcome.21
In Taiwan, during 2003 SARS-CoV-1 outbreak, the convalescent plasma taken from O blood type fully recovered patients for the infected healthcare worker resulted in zero viral load after 24 h of transfusion. Moreover, after convalescent plasma therapy one infected pregnant healthcare worker deliver healthy newborn baby with positive anti-SARS-CoV1 IgG. Indicated that the possibility of passive immunity transfer of anti-SARS-CoV-1 antibody from the mother to the newborn.22
Recently, it has been reported that discharged patients in China and elsewhere were 23 testing positive after recovering. The situation was as unclear. Animal model based study was carrier out to reveals the reinfection and relapse of COVID-19. After treatment with convalescent plasma the pre-infected monkey shown neither viral loads in nasopharyngeal and anal swabs along timeline nor viral replication in all primary tissue compartments at 5 days post-reinfection.23 Generally, the viremia peaks most probably is high in the first week of the viral infection. Therefore, providing the convalescent plasma as early as the viral infection would make it more effective. 24,25
At China where the epicenter of COVID-19, at currently in 2020 Convalescent plasma therapy has been used as a potential therapy for SARS-CoV-2 infected sever patients. In chia this able to cure 7 patients out of 10 patients. The procedure, important, profession and all technical details experiences shared from China, are in the reference .24