Strong recommendation based on high-certainty evidence against CCP for unselected hospitalized patients with moderate, severe disease
MONDAY, Aug. 15, 2022 (HealthDay News) — In a clinical guideline published online Aug. 16 in the Annals of Internal Medicine, recommendations are presented for the appropriate use of COVID-19 convalescent plasma (CCP).
Lise J. Estcourt, M.B. B.Chir., D.Phil., from the University of Oxford in the United Kingdom, and colleagues developed clinical practice guidelines for appropriate use of CCP for the Association for the Advancement of Blood and Biotherapies (AABB). The guidelines were based on two living systematic reviews of randomized controlled trials (RCTs) from Jan. 1, 2019, to Jan. 26, 2022; data were included from 33 RCTs with 21,916 participants.
The AABB suggests transfusion of CCP in addition to the usual standard of care for COVID-19 outpatients at high risk for disease progression (weak recommendation; moderate-certainty evidence). For unselected hospitalized persons with moderate or severe disease, the AABB recommends against CCP transfusion (strong recommendation; high-certainty evidence); this recommendation does not apply to immunosuppressed patients or those without antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In its entirety, the clinical practice guideline contains five specific recommendations. CCP is most effective when infected patients are transfused with high neutralizing titers early after onset of symptoms.
“Given the rapidly changing landscape of SARS-CoV-2 variants, the variability of host immune responses due to prior infection and vaccination, and the growing availability of new antiviral therapies, including monoclonal antibodies, the clinical niche for CCP remains uncertain,” write the authors of an accompanying editorial.
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