Convalescent Plasma for Infectious Diseases: Historical Framework and Use in COVID-19

Abstract

Convalescent plasma has emerged as a promising therapeutic agent for patients with coronavirus disease 2019 (COVID-19), has received emergency use authorization, and is being widely used during the COVID-19 pandemic. Passive antibody therapy via plasma or serum has been successfully used to treat infectious diseases for more than a century. Passive antibody administration is based on the presumption that convalescent plasma or serum contains therapeutic antibodies that can be passively transferred to the plasma recipient. There are numerous examples in which convalescent plasma has been used successfully as post-exposure prophylaxis and treatment of infectious diseases, including previous coronavirus outbreaks. In the context of the COVID-19 pandemic, convalescent plasma was demonstrated to be safe and potentially effective among patients infected with COVID-19. This review provides an overview of the historical uses of convalescent plasma therapy, summarizes current evidence for convalescent plasma use for COVID-19, and highlights future antibody therapies.

Figure 1

Schematic illustrating the use of convalescent plasma for COVID-19. An individual who was sick with COVID-19 and currently recovered (COVID-19 Survivor) has blood drawn and screened for virus neutralizing antibodies. Following identification of those with high levels of neutralizing antibody, plasma containing these virus neutralizing antibodies can be administered to individuals currently sick with COVID-19. (Adapted from [26].)