Blood Bank, Hospital Sírio-Libanês, São Paulo, Brazil.
Corporate Medical Affairs, Vitalant, Scottsdale, AZ, USA.
Vox Sang. 2021 Sep;116(8):872-879. doi: 10.1111/vox.13096. Epub 2021 Mar 27.
The lack of definitive treatment or preventative options for COVID-19 led many clinicians early on to consider convalescent plasma (CCP) as potentially therapeutic. Regulators, blood centres and hospitals worldwide worked quickly to get CCP to the bedside. Although response was admirable, several areas have been identified to help improve future pandemic management.
A multidisciplinary, multinational subgroup from the ISBT Working Group on COVID-19 was tasked with drafting a manuscript that describes the lessons learned pertaining to procurement and administration of CCP, derived from a comprehensive questionnaire within the subgroup.
While each country's responses and preparedness for the pandemic varied, there were shared challenges, spanning supply chain disruptions, staffing, impact of social distancing on the collection of regular blood and CCP products, and the availability of screening and confirmatory SARS-CoV-2 testing for donors and patients. The lack of a general framework to organize data gathering across clinical trials and the desire to provide a potentially life-saving therapeutic through compassionate use hampered the collection of much-needed safety and outcome data worldwide. Communication across all stakeholders was identified as being central to reducing confusion.
The need for flexibility and adaptability remains paramount when dealing with a pandemic. As the world approaches the first anniversary of the COVID-19 pandemic with rising rates worldwide and over 115 million cases and 2·55 million deaths, respectively, it is important to reflect on how to better prepare for future pandemics as we continue to combat the current one.
由于缺乏针对 COVID-19 的明确治疗或预防选择,许多临床医生早期考虑使用恢复期血浆(CCP)作为潜在的治疗方法。全球的监管机构、血液中心和医院迅速采取行动,将 CCP 送到床边。尽管反应令人钦佩,但仍有几个方面需要加以改进,以帮助改善未来的大流行管理。
ISBT 工作组内的一个多学科、跨国小组负责起草一份手稿,描述与 CCP 的采购和管理相关的经验教训,这些经验教训源自小组内的一份全面调查问卷。
虽然每个国家对大流行的反应和准备情况各不相同,但也存在共同的挑战,包括供应链中断、人员配备、社交距离对常规血液和 CCP 产品采集的影响,以及供者和患者的 SARS-CoV-2 筛查和确证检测的可用性。缺乏组织临床试验数据收集的通用框架,以及通过同情使用提供潜在救生治疗的愿望,阻碍了全球范围内急需的安全性和结果数据的收集。所有利益相关者之间的沟通被确定为减少混乱的核心。
在应对大流行时,灵活性和适应性仍然至关重要。随着全球 COVID-19 大流行迎来一周年,全球发病率上升,分别有超过 1.15 亿例病例和 255 万人死亡,重要的是要反思如何更好地为未来的大流行做准备,同时我们继续应对当前的大流行。