Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Expert Rev Respir Med. 2023 May;17(5):381-395. doi: 10.1080/17476348.2023.2208349. Epub 2023 May 2.
When the COVID-19 pandemic struck no specific therapies were available and many turned to COVID-19 convalescent plasma (CCP), a form of antibody therapy. The literature provides mixed evidence for CCP efficacy.
PubMed was searched using the words COVID-19 and convalescent plasma and individual study designs were evaluated for adherence to the three principles of antibody therapy, i.e. that plasma 1) contain specific antibody; 2) have enough specific antibody to mediate a biological effect; and 3) be administered early in the course of disease. Using this approach, a diverse and seemingly contradictory collection of clinical findings was distilled into a consistent picture whereby CCP was effective when used according to the above principles of antibody therapy. In addition, CCP therapy in immunocompromised patients is useful at any time in the course of disease.
CCP is safe and effective when used appropriately. Today, most of humanity has some immunity to SARS-CoV-2 from vaccines and infection, which has lessened the need for CCP in the general population. However, COVID-19 in immunocompromised patients is a major therapeutic challenge, and with the deauthorization of all SARS-CoV-2-spike protein-directed monoclonal antibodies, CCP is the only antibody therapy available for this population.
在 COVID-19 大流行期间，尚无特效疗法，许多人转而使用 COVID-19 恢复期血浆（CCP），这是一种抗体疗法。文献对 CCP 的疗效提供了混合证据。
使用“COVID-19”和“恢复期血浆”这两个词在 PubMed 上进行了搜索，并根据抗体疗法的三个原则评估了各个研究设计的依从性，即血浆 1）含有特定抗体；2）具有足够的特定抗体以介导生物学效应；3）在疾病早期给药。通过这种方法，将看似相互矛盾的各种临床发现提炼成一个一致的图景，即根据抗体疗法的上述原则使用 CCP 是有效的。此外，在疾病过程的任何时间，CCP 治疗免疫功能低下的患者都是有用的。
CCP 在适当使用时是安全有效的。如今，由于疫苗和感染，大多数人类对 SARS-CoV-2 都有一定的免疫力，这减少了普通人群对 CCP 的需求。然而，免疫功能低下的 COVID-19 患者是一个重大的治疗挑战，随着所有 SARS-CoV-2 刺突蛋白导向的单克隆抗体的授权取消，CCP 是该人群唯一可用的抗体疗法。
