WHO issues new recommendations for the use of Convalescent plasma therapy in COVID-19 patients

Convalescent plasma (blood plasma from someone who has recovered from covid-19) is not recommended for covid-19 patients, according to a WHO Guideline Development Group of worldwide specialists published today in The BMJ.

Despite its original promise, current evidence indicates that it does not improve survival or decrease the need for mechanical breathing, it is costly and time-consuming.

As a result, the WHO strongly advises against using convalescent plasma in patients with non-severe disease, and strongly advises against using it in patients with severe and critical illness, unless in the context of a randomized controlled trial (RCT).

The guidelines are based on data from 16 trials that included 16,236 patients with non-severe, severe, or serious covid-19 infection.

The group evaluated evidence measuring relative benefits and harms, values and preferences, and feasibility difficulties in making their recommendations. 

The panel’s strong recommendation for patients with non-severe illness reflects its belief that drug treatment in patients with a low risk of mortality and other significant clinical outcomes is not justified.

Moreover, while convalescent plasma should not be used routinely in any patient, regardless of how seriously ill they are, the panel agreed that there was enough ambiguity in patients with severe and critical disease to merit the continuation of RCTs.

They also mentioned various practical hurdles, such as the requirement to find and evaluate potential donors, as well as collect, store, and administer donor plasma, which they claim restricts the viability and usefulness of the technology.

After carefully analyzing all of the facts, the panel concluded that practically all well-informed patients would refuse convalescent plasma.

Today’s guidance supplements previous recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids in patients with severe or critical covid-19; conditional recommendations for the use of neutralizing monoclonal antibodies in selected patients; and a prohibition on the use of ivermectin and hydroxychloroquine in all covid-19 patients, regardless of disease severity.

Source: WHO

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