COVID-19 Convalescent Plasma Therapy, 2022 AABB Guidelines Recommended at a Glance!

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Convalescent plasma (CP) therapy is a classic treatment that has played an important therapeutic role

COVID-19 convalescent plasma (CCP) has become a potential treatment for COVID-19

➤ For outpatients with COVID-19 at high risk of disease progression, the AABB recommends CCP infusions

Rationale: Overall, CCP is biologically plausible

➤AABB does not recommend CCP infusion

Rationale: CCP appears to be relatively safe, the vast majority of adverse events are mild, transient reactions, and death is very rare

➤For inpatients with COVID-19 who have no antibodies to SARS-CoV-2 detected at the time of admission, CCP infusions
should be given in addition to usual standards of care.

(Weak recommendation, low certainty of evidence)

Why: Throughout history, CP has always been most effective when delivered early in the course of
disease.

In immunocompetent patients, the lack of a detectable antibody response can represent early infection
.

➤ For hospitalized patients with COVID-19 who have previously been immunosuppressed, CCP infusions
should be given in addition to usual standards of care.

(Weak recommendation, low certainty of evidence)

Rationale: Patients with prior immunosuppression do not respond well to the SARS-CoV-2 vaccine and are at highest
risk of serious complications from COVID-19.

In immunosuppressed patients, CCP may be beneficial because the antibodies provided by CCP help neutralize the virus
in people who are unable to produce an antibody response.

➤AABB does not recommend CCP prophylactic infusions
in uninfected people who have close contact with people with COVID-19.

(Weak recommendation, low certainty of evidence)

Rationale: AABB does not recommend preventive CCP infusions because there is no conclusive evidence of benefit
from CCP infusions in this setting.

➤ High and titer CCP infusions are most effective
in patients with early infection after symptom onset.

For outpatients, CCP infusions are best given within 5 days of symptom onset, and CCP infusions remain effective for 9 days after symptom onset
.

In addition to time, CCP in high school and antibody titers is most effective and can generally be obtained
in people with primary infection as well as vaccination.

In summary, AABB recommends high-titer CCP infusions for outpatients at risk of disease progression, undetected SARS-CoV-2 antibodies, and immunosuppressed patients; CCP infusion
is not recommended in patients with advanced COVID-19.

Estcourt LJ, Cohn CS, et al.
Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma.
Ann Intern Med.
2022 Aug 16.
doi: 10.
7326/M22-1079.