COVID-19 Convalescent Plasma (CCP)
What is convalescent plasma?
Convalescent = from a recovered patient
Plasma = liquid portion of blood
COVID-19 convalescent plasma (CCP) = plasma from a recovered COVID-19 patient
Blood plasma (referred to as plasma later) is the noncellular, liquid portion of the blood. When isolated, it is a light-yellow color, as seen in the photo above. Plasma contains certain components that make it desirable for medical use, such as antibodies, blood platelets, and clotting factors.
Convalescent plasma, or plasma from an individual who has recovered from a certain disease, contains antibodies, which are blood proteins that recognize certain foreign invaders, or pathogens, and help neutralize them. Convalescent plasma therapy is a therapy in which convalescent plasma is transfused into a patient currently fighting an infectious disease. The goal of this therapy is to provide antibodies that specifically target and neutralize a pathogen, such as SARS-CoV-2, the virus responsible for COVID-19.
Ultimately, in the case of COVID-19, the additional antibodies that target SARS-CoV-2 from a CCP transfusion could potentially give the immune system the resources it needs to turn the tide against COVID-19.
Additionally, donated CCP can be further processed by researchers to isolate antibodies to develop other therapies, such as a hyperimmune globulin (H-Ig). Early in the pandemic, plasma companies formed the CoVIg-19 Plasma Alliance, a coalition to research and develop CoVIg-19, a H-Ig specific to COVID-19. Currently, H-Ig has moved into a NIH funded clinical trial that will be complete by early 2021, if not later this year.
Direct CCP transfusion and hyperimmune globulin are playing an important role in the fight against COVID-19. While CCP can be used immediately in a transfusion, H-Ig has certain advantages, such as a standard, higher antibody concentration.* Both are being utilized to treat patients in clinical trials at the moment.
Current Therapies for COVID-19
The SARS related coronavirus 2 (SARS-CoV-2) pandemic presents a rapidly evolving challenge to global health. Although researchers, virologists, and scientists around the world are teaming up to find a vaccine and successful therapies, few have substantial clinical trials that support them. It will also take months to pass the minimum phases of testing to evaluate the safety, efficacy, therapeutic effect, and optimal treatment conditions, among other factors.† This applies to drugs, antibody therapies, and vaccines.
Because of this, researchers are looking for therapies that can combat COVID-19 immediately. One of the most efficacious and promising therapies has been convalescent plasma therapy.§ Due to early anecdotal evidence that supports its safety and efficacy, the FDA, in partnership with the Mayo Clinic, created an Expanded Access Program (EAP) for CCP. The EAP allows hospitals and organizations to engage in a more streamlined process to obtain plasma in order to treat severe cases of COVID-19.‡
Additionally, the FDA granted CCP emergency use authorization (EUA) on August 23rd, allowing CCP to be used by “health care providers, as appropriate, to treat suspected or laboratory-confirmed COVID-19 in hospitalized patients with COVID-19” (FDA, 2020). In other words, CCP can be used on a broader basis, giving patients greater access and enabling more critical randomized clinical trials to be completed to further evaluate the efficacy of CCP. This EUA is essential to determining the proper treatment conditions, such as the optimal administration of CCP during the clinical course of COVID-19.
Certain drugs have also been given the emergency use authorization by the FDA, such as Remdesivir, an antiviral drug that has shown promising results on reducing recovery time. However, the FDA acknowledges that there is a limited understanding of the safety and effectiveness of Remdesivir and drugs under emergency use authorization.
Doctors currently recommend a multi-faceted approach to treating severe and/or life threatening cases of COVID-19, through the use of multiple treatments like CCP and drugs.
Relevance of CCP and the Convalescent Plasma Initiative
While the FDA, Mayo Clinic, hospitals, and organizations have web pages that encourage CCP donations, awareness of this therapy and donations as a way to contribute against COVID-19 is lacking. In addition, the health care system is somewhat lagging behind in knowledge of this leading therapy. For instance, hospital call centers often struggle to connect potential donors with organizations that can collect plasma donations or even are aware of CCP as a therapy.
The relevance and use of CCP against COVID-19 is dependent on certain evolving factors. Some of these factors include the prevalence and distribution of COVID-19, widespread awareness of CCP and the process to donate, the results of ongoing clinical trials, and the development of other drugs, therapies, and vaccines. However, it is important to note that CCP will be in high demand for the foreseeable future, to supply both direct transfusions for convalescent plasma therapy, to create and supply concentrated antibody therapies like H-Ig, and to supply future research.
Within the Mayo Clinic’s EAP, there were more than 70,000 patients treated with direct CCP transfusions, and this number has rapidly increased under the emergency use authorization. Regardless of how long convalescent plasma therapy will be relevant as a treatment for COVID-19, the demand for CCP at this time is high and may serve as the last option for struggling patients.
* Comparing CCP Transfusion and Hyperimmune Globulin (H-Ig)
For more information comparing these two treatment options, please visit the CoVIg-19 Plasma Alliance website.
† Clinical Trial Information
Refer to our FAQ page to learn additional information on phases of clinical trials.
§ Further Studies and Information
If you would like to learn more about CCP and current studies examining its safety and efficacy, please visit our page on current literature.
‡ FDA and EAP Information
Additional information on the EAP can be found on our FAQ page.