Role of Convalescent Plasma Therapy in Successful Prevention and Treatment of Covid-19 Novel Corona Virus Critical Patients, In 2020 Global Pandemic

The Main theme of this Article is to prove the effectiveness and use of Convalescent Plasma therapy in successful prevention and treatment of COVID-19 novel corona Virus critical Patients in 2020 Global Pandemic...


Introduction
Use of Convalescent Plasma for COVID-19, two case series were recently compiled in China examining the therapeutic use of CP in patients with COVID-19 [1]. Between the two studies a total of 15 patients were treated all were severely ill before transfusion and were positive for SARS-CoV-2 by PCR. Donor plasma neutralizing antibody titer was tested (≥1:40 in the 5-patient study; ≥1:640 in systems. Protective cross-reactivity of antibodies against measles and other known viral infections has been postulated primarily as a result of the initial observations of asymptomatic and mild COVID-19 in children. Uncontrolled case series have demonstrated virus-neutralizing effect of convalescent plasma supporting its efficiency at early stages of contracting SARS-CoV-2. Given the variability of the virus structure, the utility of convalescent plasma is limited to the geographic area of its preparation, and for a short period of time. Intravenous immunoglobulin may also be protective in view of its nonspecific antiviral and immunomodulatory effects. Finally, human monoclonal antibodies may interact with some SARS-CoV-2 proteins inhibiting the virus-receptor interaction and prevent tissue injury [2] (Figure 1).

Figure 1.
As transfusion medicine specialists we understood the potential that convalescent plasma could play early in the management of patients with COVID-19 [3]. However, with no guidance from the Food and Drug Administration (FDA) we couldn't begin to establish a program for COVID-19 Convalescent Plasma (CCP). That changed on March 24, 2020, when the FDA issued its first guidance on this topic. The rules were clearly identified subjects with molecularly confirmed COVID-19, and after they have been asymptomatic for 14 days, test them to confirm they were no longer infectious and that they are eligible to donate CCP. With a small hospital-based donor center an academic medical center that had implemented molecular testing for COVID-19 and an established Clinical Research Unit (CRU), we realized we were set to establish and implement a program quickly [3]. pandemic [4]. Therapeutic options including antimalarials, antivirals, antibiotics and vaccines are under study. Meanwhile the current pandemic has called attention over old therapeutic tools to treat infectious diseases. Convalescent plasma (CP) constitutes the first option in the current situation, since it has been successfully used in other coronaviruses outbreaks. Herein, we discuss the possible mechanisms of action of CP and their repercussion in COVID-19 pathogenesis including direct neutralization of the virus, control of an overactive immune system (i.e., cytokine storm, Th1/ Th17 ratio, complement activation) and immunomodulation of a hypercoagulable state [4] (Figure 2).
Previous study reported a higher severe status rate and mortality rate in male patients in China [5]. However, the reason underlying this difference has not been reported. Convalescent plasma containing high level of SARS-CoV-2 IgG antibody has been used in clinical therapy and achieved good effects in China. In this study to compare the differences of SARS-CoV-2 IgG antibody between male and female patients a total number of 331 patients confirmed SARS-CoV-2 infection were enrolled. Serum of these patients were collected during hospitalization and detected for SARS-CoV-2 IgG antibody. Our data showed that the concentration of IgG antibody in mild general and recovering patients showed no difference between male and female patients. In severe status compared with male patients, there were more female patients having a relatively high concentration of serum SARS-CoV-2 IgG antibody. In addition, the generation of IgG antibody in female patients was stronger than male patients in disease early phase.
Our study identified a discrepancy in SARS-CoV-2 IgG antibody level in male and female patients which may be a potential cause leading to different outcome of COVID-19 between sex [5].
As more and more patients recover from coronavirus disease 2019  in the coming weeks convalescent plasma will become increasingly accessible as a treatment option [6]. The    It should be noted that these patients were also supported by a mechanical ventilator and had also received antiviral agents (combinations of lopinavir, ritonavir, interferon α-1b, favipiravir, arbidol, and/or darunavir) and methylprednisolone a steroid [10].

Use of convalescent plasma transfusions could be of great value in the current pandemic of coronavirus disease (COVID-19) given
the lack of specific preventative and therapeutic options [11]. This The recent emergence of COVID-19 pandemic has reassessed the usefulness of historic convalescent plasma transfusion (CPT) [12]. This review was conducted to evaluate the effectiveness of CPT therapy in COVID-19 patients based on the publications reported till date. We included 5 studies reporting CPT to COVID-19 patients.
The main findings from available data are as follows: patients [12]. As deaths from coronavirus disease 2019 (COVID- 19) continue to mount desperation has driven physicians to try therapies backed by little or no evidence [13]. Taken from healthy people or in the earliest reported cases animals who have recovered from the infectious disease of interest, antibody-rich convalescent plasma is thought to give recipients immune systems a running start.
To explain how desperate the need is we probably have at least 300 COVID-19patients in the hospital today over a third of them intubated anesthesiologist Elliott Bennett-Guerrero MD, said in mid-April. He's the principal investigator of a just launched convalescent plasma trial at Stony Brook Hospital in New York with a planned enrollment of up to 500 hospitalized patients with COVID-19 a third of whom probably will be intubated. We are at lightning speed ramping up production and processes for collecting convalescent plasma Bennett-Guerrero explained. We do not know if this is safe and effective Bennett Guerrero acknowledged in an interview. We hope it is because we desperately want to help our patients [13].  Plasma and H-IVIG of recovered patients are a tried and tested approach that could prove helpful in the short term [16].
The pandemic spread of a novel coronavirus SARS coronavirus-2 (SARS-CoV-2) as a cause of acute respiratory illness named Covid-19, is placing the healthcare systems of many countries under unprecedented stress [17]. Global economies are also spiraling  [19]. Table 2 shows Antibody levels of six Donors recovered from COVID-19 (Table 3).