Effects and Safety of Convalescent Plasma Administration in a Group of Polish Pediatric Patients with COVID-19: A Case Series
Despite the enormous advances in knowledge about the SARS-CoV-2 infection, the optimal treatment for COVID-19 is still not well defined The use of convalescent plasma seems to be a promising method of treatment but requires further evaluation Although it is usually mild, in children with underlying chronic diseases, the course of SARS-CoV-2 infection may be very severe We described a series of 13 pediatric patients (mean age 10 4 years, median 12) treated with convalescent plasma as a method of COVID-19 therapy Medical history, with particular emphasis on comorbidities, clinical course, laboratory parameters, supportive treatment and virus elimination time, were analyzed The mean hospitalization time was 22 6 days (median 20) The most common abnormalities included increased levels of C-reactive protein, D-dimer, and lymphopenia Median time from symptom onset to convalescent plasma transfusion was 10 6 days (median 7 days) Six patients (46 2%) had a viral clearance on RT-PCR method from a nasopharyngeal swab within 3 days of transfusion, while in the remaining patients the mean elimination time was 12 1 days (median 6 days) Clinical improvement was achieved in all patients;no adverse effects were found in any of the cases Convalescent plasma may be a promising treatment for COVID-19 in children
Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study
Pathogens (Basel, Switzerland). 2021;10(5)
Hand, foot, and mouth disease (HFMD) is highly prevalent in East and Southeast Asia. It particularly affects children under five years of age. The most common causative agents are coxsackieviruses A6 and A16, and enterovirus A71 (EV71). The clinical presentation is usually mild and self-limited, but, in some cases, severe and fatal complications develop. To date, no specific therapy or worldwide vaccine is available. In general, viral infection invokes both antibody and cell-mediated immune responses. Passive immunity transfer can ameliorate the severe symptoms of diseases such as COVID-19, influenza, MERS, and SARS. Hyperimmune plasma (HIP) from healthy donors with high anti-EV71 neutralizing titer were used to transfuse confirmed EV71-infected children with neurological involvement (n = 6). It resulted in recovery within three days, with no neurological sequelae apparent upon examination 14 days later. Following HIP treatment, plasma chemokines were decreased, whereas anti-inflammatory and pro-inflammatory cytokines gradually increased. Interestingly, IL-6 and G-CSF levels in cerebrospinal fluid declined sharply within three days. These findings indicate that HIP has therapeutic potential for HFMD with neurological complications. However, given the small number of patients who have been treated, a larger cohort study should be undertaken. Successful outcomes would stimulate the development of anti-EV71 monoclonal antibody therapy.
THE USE OF CONVALESCENT PLASMA FOR PEDIATRIC PATIENTS WITH SARS-COV-2: A SYSTEMATIC LITERATURE REVIEW
Transfusion and Apheresis Science. 2020;:103043-103043
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019 (COVID-19), a severe illness leading to pneumonia, multiorgan failure, and death With this study, we performed a systematic review of the literature and ongoing clinical trials on convalescent plasma therapy in pediatric patients with COVID-19 The electronic databases Medline PubMed, Scopus, and Web Of Science were searched Also, clinical trials registries were searched for potentially eligible studies A total of 90 records were retrieved after duplicate removal Eight studies were case reports of children treated with convalescent plasma therapy (14 children, age range, 9 weeks to 18 years);5 children had a chronic disease During the hospital stay, 5 received drugs (e g , remdesivir) in addition to convalescent plasma therapy No convalescent plasma therapy-related adverse events were reported in 5 studies and 3 made no mention of adverse events Seven studies concluded that convalescent plasma therapy is or could be a useful therapeutic option;one study made no claims Only 3 of the 13 retrieved trials underway were planned exclusively for children This is the first systematic review of the literature regarding convalescent plasma therapy for COVID-19 in children We found insufficient clinical information on the safety and efficacy of convalescent plasma therapy in children Nevertheless, the positive outcomes of the few case reports published to date suggest that convalescent plasma therapy may be of potential benefit Further research with well-designed and powered clinical trials is needed