Is there any revival of the use of plasma therapy or neutralizing convalescent antibody therapy to treat SARS-CoV-2 variants and are we rethinking preparedness plans?

Fresh frozen plasma for neutralizing SARS-CoV-2: "An exploratory cross-sectional study and review of the state of the art"

Restitution of humoral immunodeficiency is essential to clear SARS-CoV-2. Intravenous unspecific immunoglobulins are expensive and restricted. So recently donated fresh frozen plasma (FFP) could be useful in this scenario but, are all units neutralizing against SARS-CoV-2? We explored this on 52 donations obtained from "Centro de Transfusión, Tejidos y Células de Málaga, Spain", from April to June 2022. Donors status about SARS-CoV-2 previous infection or vaccination was unknown. Neutralizing activity (at dilutions≥1/160) against real Delta (not circulating), BA.2 (dominant circulating variant), BA.5 (irrupting variant), and BQ.1.1 and XBB.1.5 (not circulating yet) was determined. Higher anti-Spike IgG antibodies cut-offs predicted efficacy of FFP. Different cut-offs have been reported in the literature, but all papers have in common that levels over the higher range of quantification can predict neutralizing activity of recently donated FFP against circulating variants of concern, if used early after donation, not requiring clinical data from donors.

Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review

Since late 2019, the new SARS-CoV-2 virus belonging to the Coronaviridae family has been responsible for COVID-19 pandemic, a severe acute respiratory syndrome. Several antiviral therapies, mostly derived from previous epidemics, were initially repurposed to fight this not rarely life-threatening respiratory illness. Among them, however, the only specific antibody-based therapy available against SARS-CoV-2 infection during the first year of the pandemic was represented by COVID-19 convalescent plasma (CCP). CCP, collected from recovered individuals, contains high levels of polyclonal antibodies of different subclasses able to neutralize SARS-CoV-2 infection. Tens of randomized controlled trials have been conducted during the last three years of the pandemic to evaluate the safety and the clinical efficacy of CCP in both hospitalized and ambulatory COVID-19 patients, whose main results will be summarized in this narrative review. In addition, we will present the current knowledge on the development of anti-SARS-CoV-2 hyperimmune polyclonal immunoglobulins.

Chinese expert consensus on the management of patients with hematologic malignancies infected with SARS-CoV-2

In December 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became dominant in China due to its high infectivity and lower mortality rate. The risk of critical illness and mortality among patients with hematologic malignancies who contracted SARS-CoV-2 was particularly high. The aim of this study was to draft a consensus to facilitate effective treatments for these patients based on the type and severity of the disease. Following the outbreak of the novel coronavirus in China, a steering committee consisting of experienced hematologists was formed by the Specialized Committee of Oncology and Microecology of the Chinese Anti-Cancer Association. The expert group drafted a consensus on the management and intervention measures for different types of hematologic malignancies based on the clinical characteristics of the Omicron variant of the SARS-CoV-2 infection, along with relevant guidelines and literature. The expert group drafted independent recommendations on several important aspects based on the epidemiology of the Omicron variant in China and the unique vulnerability of patients with hematologic malignancies. These included prophylactic vaccinations for those with hematologic malignancies, the use of plasma from blood donors who recovered from the novel coronavirus infection, the establishment of negative pressure wards, the use of steady-state mobilization of peripheral blood hematopoietic stem cells, the provision of psychological support for patients and medical staff, and a focus on maintaining a healthy intestinal microecology.