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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 111-112

Triage of convalescent plasma – A theoretical consideration or a real necessity?


1 Regional Centre for Transfusion Medicine, Medical University of Bialystok, Bialystok, Poland
2 Regional Centre for Transfusion Medicine; Department of Hematology, Medical University of Bialystok, Bialystok, Poland

Date of Submission02-Mar-2021
Date of Decision03-May-2021
Date of Acceptance04-May-2021
Date of Web Publication29-May-2021

Correspondence Address:
Dr. Tomasz Wasiluk
Regional Centre for Transfusion Medicine, Medical University of Bialystok, Bialystok
Poland
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gjtm.gjtm_18_21

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How to cite this article:
Wasiluk T, Boczkowska-Radziwon B, Zebrowska A, Radziwon P. Triage of convalescent plasma – A theoretical consideration or a real necessity?. Glob J Transfus Med 2021;6:111-2

How to cite this URL:
Wasiluk T, Boczkowska-Radziwon B, Zebrowska A, Radziwon P. Triage of convalescent plasma – A theoretical consideration or a real necessity?. Glob J Transfus Med [serial online] 2021 [cited 2021 Dec 7];6:111-2. Available from: https://www.gjtmonline.com/text.asp?2021/6/1/111/317123



Sir,

The COVID-19 pandemic is not slowing down, as we can see both globally and in Europe, where the 14-day COVID-19 case notification rate has already reached 496.0 per 100,000 inhabitants.[1] Individual countries are trying to modify their strategies both in terms of nonmedical interventions and with respect to hospital treatment. Poland is among the countries with the most dynamically growing number of new SARS-CoV-2 infections, as evidenced by the 14-day incidence rate of over 500 cases per 100,000 population (recorded on November 1, 2020),[1] which compared to <20 cases per 100,000 population recorded on 13 September 2020,[2] appears to be more than worrying. Unfortunately, the sharp increase in the number of infections in Poland also translates into the number of deaths due to COVID-19, which has currently reached over 400 deaths a day.[1] The uncontrolled rise in infection rates and lack of effective forms of pharmacotherapy seem to be the reason for the recently observed rapid increase in the number of convalescent plasma (CPP) transfusions [Figure 1]. According to the Recommendations of the Polish Association of Epidemiologists and Infectiologists,[3] CPP is indicated as a primary treatment in fully symptomatic COVID-19 patients, with O2 saturation <95%, optimally within first week after disease onset. However, we are aware that, due to the dramatic epidemiological situation, the above criteria are not always strictly followed, which may lead to the exhaustion of CPP stocks.
Figure 1: Consumption, current supplies, and the number of convalescent plasma therapeutic doses collected in Poland from October 3, 2020 until November 13, 2020. *From the moment of the commencement of the convalescent plasma collection and transfusion program in Poland until October 2, 2020, a total of 3686 convalescent plasma units were collected, of which 1473 units were transferred to hospital treatment. Of all the convalescent plasma units collected, 582 did not meet the required anti-SARS-CoV-2 antibody titer criteria

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As a blood center coordinating the management of CPP resources, we are concerned that the ever growing infection rate will force us to introduce CPP triage procedures. The studies carried out so far suggest that patients who are in the early days of infection ought to have priority with regard to CPP transfusions, because it is them who can benefit the most from it (reduction of early and late mortality).[4] Unfortunately, we are already faced with having to make difficult decisions regarding CPP distribution, depending on the level of anti-SARS-CoV-2 antibodies found in individual donations, which, according to literature reports, seems to significantly define the effectiveness of the CPP therapy.[5] We all truly hope that such a scenario will never become an actual necessity.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Weekly Surveillance Report on COVID-19. European Centre for Disease Prevention and Control. Available from: https://www.ecdc.europa.eu/en/covid-19/surveillance/weekly-surveillance-report. [Last accessed on 2020 Nov 12].  Back to cited text no. 1
    
2.
Increased Transmission of COVID-19 in the EU/EEA and the UK – Twelfth Update. European Centre for Disease Prevention and Control. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-risk-assessment-increased-transmission-12th-update-september-2020.pdf. [Last accessed on 2020 Nov 12].  Back to cited text no. 2
    
3.
Flisiak R, Parczewski M, Horban A, Jaroszewicz J, Kozielewicz D, Pawłowska M, et al. Management of SARS-CoV-2 infection: Recommendations of the Polish Association of Epidemiologists and Infectiologists. Annex no. 2 as of October 13, 2020. Pol Arch Intern Med 2020;130:915-8.  Back to cited text no. 3
    
4.
Joyner MJ, Senefeld JW, Klassen SA, Mills JR, Johnson PW, Theel ES, et al. Effect of convalescent plasma on mortality among hospitalized patients with COVID-19: Initial three-month experience. medRxiv 2020. [doi: 10.1101/2020.08.12.20169359].  Back to cited text no. 4
    
5.
Maor Y, Cohen D, Paran N, Israely T, Ezra V, Axelrod O, et al. Compassionate use of convalescent plasma for treatment of moderate and severe pneumonia in COVID-19 patients and association with IgG antibody levels in donated plasma. EClinicalMedicine 2020;26:100525.  Back to cited text no. 5
    


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