Due to the limitations of COVID-19 treatment and in the absence of licensed antiviral for COVID-19, the historical choice of therapeutic convalescent plasma (CP) is considered especially against RNA viruses .It was known that convalescent plasma does not only neutralize the pathogens but provide passive immunomodulatory properties that allows the recipient to control the exaggerated inflammatory cascade. However, still there is a lack of understanding of the mechanism of action of CCP therapeutic components. Reports from open label trials and case series show that CCP is safe and might be effective in severe cases with COVID-19 . Therefore, the World health organisation (WHO) and Food and Drug Administration (FDA) issued guidelines for the CCP usage and standardised the donor selection , which was further supported by Emergency use Authorisation (EUA) . Therefore, the aim in the current study is to assess the effect of CCP on time to clinical improvement, hospital mortality and to evaluate the changes on oxygen saturation and laboratory markers (lymphocyte counts and C-reactive protein) compared with standard treatment alone in patients with moderate or severe COVID-19 disease.
This is a prospective multicenter interventional observational study will be conducted in 4
major tertiary hospitals (Al-Sabah, Farwaniya , Mubarak Al-Kabeer and Jahra) in Kuwait .
Drug: COVID-19 Convalscent Plasma
The source convalescent plasma is typically collected from individuals who have recovered from COVID-19 which contains antibodies titer against SARS-CoV-2 and is administered to patients with COVID-19. Donor eligibility criteria and qualification are based on American Accredited Blood Banks ( AABB) standards , including questionnaires and relevant transfusion-transmitted infections testing are performed. Furthermore, pathogen inactivation will be performed for each unit, CCP was only collected from individuals who meet all donor eligibility requirements (21 CFR 630.10 and 21 CFR 630.15). Donors must be found positive at a diagnostic test of nasopharyngeal swab at the time of illness and positive serological test for SARS-CoV-2 antibodies after recovery. All donors should have negative HLA antibodies.
Inclusion Criteria:
1. Patients aged ≥18 years old ( those who are younger are involved after case based
discussion)
2. Confirmed laboratory diagnosis with SARS-CoV-2 ,and admission diagnosis of SARS-CoV-2.
3. Patients with moderate or severe COVID-19 (moderate COVID-19 disease defined as the
presence of any signs of pneumonia (fever, cough, dyspnoea fast breathing) including
SpO2 >90 on room air , but no signs of severe pneumonia (severe pneumonia have the
above plus one of the following: respiratory rates >30 breaths/minutes or SpO2<90% on
room air), or admission to intensive care unit (ICU) for respiratory support (i.e.high
flow nasal cannula, non-invasive mechanical ventilation and intubation).
Exclusion Criteria:
1. -Contraindication to transfusion (volume overload, history of anaphylaxis to blood
products).
2. - Patients presenting with acute severe multiorgan failure, hemodynamic instability.
3- Severe disseminated coagulopathy (DIC), septic shock and those with expected survival of
less than 48 hours.
Ministry Of Health
Kuwait, Kuwait
Investigator: Sondus AlSharidah, MD
Contact: 0096566691663
salsharidah@moh.gov.kw
Investigator:
Sundos Alsharida
0096566691663
salsharidah@moh.gov.kw
Sondus AlSharidah, MD, Principal Investigator
MOH