Convalescent plasma and COVID-19: Time for a second—second look?

In this review article, Mayo Clinic researchers highlight some of their experiences leading the US Convalescent Plasma Program at the beginning of the pandemic in the spring and summer of 2020. This piece includes a brief summary of how the program emerged and high-level lessons learned. The authors also share their impressions about why convalescent plasma (CP) was used at scale in the United States, early in the pandemic, and share ideas that might inform the use of CP in future outbreaks of novel infectious diseases.

Highlights of the review:

  • Convalescent plasma (CP) has been used worldwide to treat COVID-19 since the start of the pandemic. In the United States alone, more than 500,000 hospitalized COVID-19 patients received CP since March 2020.
  • CP will almost always be the first antibody therapy available to treat an outbreak of a novel infectious disease.
  • Assay systems are necessary to understand the properties of CP and other elements of the immune response generated against a novel infectious agent.
  • Eleven questions — beyond the obvious regulatory issues like streamlined and coordinated approaches to IRB oversight, informed consent and data management — that need to be answered about what it takes to conduct randomized controlled trials in a pandemic.