WHO advises against use of convalescent plasma for COVID-19 treatment
Covid-19 convalescent plasma, also known as "survivor's plasma", is transfusion of blood plasma from patients who have recovered from Covid-19. Last year, the US Food and Drug Administration (FDA) issued an emergency use authorisation to allow use of convalescent plasma in hospitalised patients with Covid-19.
A WHO Guideline Development Group of international experts in The BMJ wrote that despite its initial promise, current evidence shows that it does not improve survival nor reduce the need for mechanical ventilation, and it is costly and time-consuming to administer.
The WHO made a strong recommendation against the use of convalescent plasma in patients with non-severe illness, and in patients with severe and critical illness, except in the context of a randomised controlled trial (RCT).
The recommendations are based on evidence from 16 trials involving 16,236 patients with non-severe, severe, and critical Covid infection.
And although convalescent plasma should not be used routinely in any patients, regardless of how severely ill they are, the panel acknowledged that there was sufficient uncertainty in patients with severe and critical illness to warrant continuation of RCTs.
The guidance adds to previous recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical Covid-19; conditional recommendations for the use of neutralising monoclonal antibodies in selected patients and against the use of ivermectin and hydroxychloroquine in patients with covid-19 regardless of disease severity.
The therapy involves transfusing plasma, the pale yellow liquid in blood that is rich in antibodies, from people who have recovered from Covid-19 into patients who have leukemia, lymphoma or other blood cancers and are hospitalised with the viral infection. The goal is to accelerate their disease-fighting response.
In August, a study led by the US National Institutes of Health (NIH) also stated that early administration of convalescent plasma does not prevent disease progression in a high-risk group of Covid-19 patients.
In May, the Indian Council of Medical Research (ICMR) dropped the plasma therapy as Covid-19 treatment, citing no significant benefit.
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