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Convalescent Plasma (CCP)

What is Covid-19 convalescent plasma (CCP)

 

Blood is often separated into its individual components, so patients can be given what they need, for example red blood cells or platelets[1]. The main four components are red cells, white cells, platelets and plasma. The latter is the fluid that carries all blood cells and components. Plasma includes a large number of proteins and substances which are often important ingredients in medicinal products.

Plasma from recovered COVID-19 patients contains antibodies that may help fight the disease that causes the illness.

Giving COVID19 patients the liquid portion of blood (plasma), obtained from those who have recovered from the virus, could lead to faster improvement of the disease because it may have the ability to fight the virus that causes COVID-19.

Why convalescent plasma

 

Beyond supportive care, there are currently no proven treatment options for coronavirus disease (COVID-19) and the related pneumonia, the infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Human convalescent plasma is an option for treatment of COVID-19. Convalescent plasma (CPP) therapy, is the administration of passive polyclonal antibody (Ab) to provide immediate immunity. The transfusion of CCP is able to neutralise the pathogen and eventually leads to its eradication from the blood circulation.

It is a classic adaptive immunotherapy that has been applied to the prevention and treatment of many infectious diseases for more than one century. Recently, the use of convalescent plasma has been studied in outbreaks of other respiratory infections, including the 2009-2010 H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic.

Limited studies on the efficiency of CCP make it important to determine through randomised case-controlled clinical trials in Europe, before routinely administering convalescent plasma to patients with COVID-19, that it is safe and effective to do so.

The plasma collected is tested, treated and in most cases, cryopreserved (in 200 to 250 ml units) and made available for clinical use.

Who are the donors of CCP

 

COVID-19 convalescent plasma must only be collected from recovered individuals if they are eligible to donate blood: age, weight, overall health/history of past diseases, risk behaviours, medical treatment, etc. criteria are taken into account as they would for a regular blood donation.

Convalescent plasma is obtained by collecting at least 14 days after complete resolution of symptoms (this duration varies from one country to another) whole blood or plasma from a patient-donor who has survived a previous infection and developed immunity against the pathogen responsible for the COVID-19.

The patients-donors may be tested by a laboratory test (depends on the country) for COVID-19 or either from one or more nasopharyngeal swab specimens or by a molecular diagnostic test from blood.

The donors are preferably male donors, or female donors (depends on the country) who have not been pregnant or female donors who have been tested since their most recent pregnancy and results interpreted as negative for a category of antibodies.

For more information on the CCP projects in your country, please contact your blood establishment – click on the link provided on the map, on the right-hand side of this page, to check its contact details.

Who can benefit from CCP – Patients

 

Depending on the countries and protocols adopted, CCP could be administrated either as a prophylactic treatment (in prevention of the disease), either/and for patients with mild/moderate symptoms, either/and for patients in a severe/critical condition (hospitalised). The patients (or his/her proxy) must have signed a consent.

In Europe, CCP will mostly be a treatment for acutely ill patients or those who may risk becoming seriously ill due to their age or pre-existing conditions (chronic disease, such as diabetes, heart problems, obesity, etc.). The patients are hospitalised and the clinical team supervises the transfusion of the convalescent plasma. Different amount ABO-compatible convalescent plasma depending on the weight of the patient, transfused at different intervals of time have been adopted in national protocols, it may be twice a dose of 200 ml (or 250 – 325 ml) of CPP on day 1, then the same amount on day 3 and 5, with a constant monitoring of potential adverse events, and efficacy of the treatment. EBA holds a repository of European protocols that are available to be shared openly.

For more information on the CCP projects in your country, please contact your blood establishment – click on the link provided on the map, on the right-hand side of this page to check its contact details.

The International Society of Blood Transfusion (ISBT) shares useful information and resources on its Covid-19 dedicated webpage.

EBA and Convalescent Plasma

 

EBA office is collecting protocols both from Blood Establishments and Clinicians to be shared among its membership in an open manner, to allow replication and sharing of knowledge and experiments among European countries. EBA acts as a coordinator in this network of establishments to best inform all parties and the European Commission. EBA is also investigating avenues for funding of pan-European initiatives on CCP both for the network of Blood Establishments working together and for national/local clinical trials on convalescent plasma.

EBA is developing an open database, platform hosted by the Commission, with data inserted directly by blood establishments.

The objectives are to facilitate and enhance immediate data reporting, knowledge sharing and between as well as to ensuring immediate availability of information on donor selection, plasma collection processes, donor adverse events, plasma characteristics and availability, clinical use – clinical trials / Managed access (“compassionate use”), recipient adverse events and the clinical results.

Blood Establishments will have the capacity to directly input their data on plasma collection into this database and to see other’s data (anonymised and GDPR compliant).

The EU CCP Database is composed of three parts that can be accessed through separate links. The first part comprises information on the participating BEs and their working protocols, the second part comprises information on the CCP donations, and the third part comprises information on the clinical outcome in recipients. The third part of the database is currently still under construction and is not yet open for data submission.

BEs should send an email to info (at) europeanbloodalliance.eu to indicate their interest in participation. They will then receive an email with a link and an access code to the registration form for BEs, and a link and a password that allows them to enter data on the CCP donation.

You do not need to be a member of EBA to participate in the programme. To register, however, you should send a request to them info (at) europeanbloodalliance.eu

If you would like to participate in the study of convalescent plasma, please contact your local or national blood establishment. Your blood establishment will also ask you for data on transfusion and clinical outcome. They will take care of entering them into the registry.

The EU CCP database

 

The following countries have informed EBA that they are initiating convalescent plasma collection or considering it for the near future:

  1. Austria
  2. Belgium: Red Cross Flanders, and Red Cross French speaking
  3. Croatia
  4. Denmark
  5. Finland
  6. France
  7. Germany
  8. Greece
  9. Hungary
  10. Iceland
  11. Ireland
  12. Italy
  13. Malta
  14. The Netherlands
  15. Norway
  16. Portugal
  17. Slovenia
  18. Spain
  19. Switzerland
  20. The United Kingdom: England, Wales, Scotland

If you wish to learn more about CCP, please contact your Blood Establishment – click on the link provided in the map, on the right hand-side of the screen.

1. Source: NHSBT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[1] Source: NHSBT

  • 17 million donations
  • 470 million population
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