The Role of Convalescent Plasma in COVID-19: A Conclusive Post-Pandemic Review DOI Creative Commons
Massimo Franchini, Daniele Focosi

Life, Journal Year: 2023, Volume and Issue: 13(12), P. 2322 - 2322

Published: Dec. 11, 2023

COVID-19 convalescent plasma (CCP) has represented the frontline response to pandemic, largely because of encouraging historical evidences in previous pandemics, biological plausibility, and initial unavailability targeted antivirals. Unfortunately, investigator-initiated randomized clinical trials 2020, launched during a stressful pandemic peak, were designed mostly at addressing main unmet need, i.e., treating critically ill hospitalized patients who unlikely benefit from any antiviral therapy. The failure most these drugs, combination with lack sponsor, led false belief that was useless. With relaxing stages, have instead mounted that, when administered properly (i.e., within 5 days onset symptoms high titers neutralizing antibodies), CCP is as effective other antivirals preventing disease progression outpatients, also reduces mortality patients. Recently, focus use been on immunosuppressed persistent seronegativity infection, where trial shown reduction mortality. Lessons learnt will be utmost importance for future pandemics.

Language: Английский

Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study DOI Creative Commons
Rachael A. Evans, Sabada Dube, Yi Lu

et al.

The Lancet Regional Health - Europe, Journal Year: 2023, Volume and Issue: 35, P. 100747 - 100747

Published: Oct. 13, 2023

Immunocompromised individuals are not optimally protected by COVID-19 vaccines and potentially require additional preventive interventions to mitigate the risk of severe COVID-19. We aimed characterise describe across immunocompromised groups as pandemic began transition an endemic phase.

Language: Английский

Citations

112
Sotrovimab: A Review of Its Efficacy against SARS-CoV-2 Variants DOI Creative Commons
Daniele Focosi, Arturo Casadevall, Massimo Franchini

et al.

Viruses, Journal Year: 2024, Volume and Issue: 16(2), P. 217 - 217

Published: Jan. 31, 2024

Among the anti-Spike monoclonal antibodies (mAbs), S-309 derivative sotrovimab was most successful in having longest temporal window of clinical use, showing a high degree resiliency to SARS-CoV-2 evolution interrupted only by appearance BA.2.86* variant interest (VOI). This success undoubtedly reflects rational selection target highly conserved epitope coronavirus Spike proteins. We review here efficacy against different variants outpatients and inpatients, discussing both randomized controlled trials real-world evidence. Although it could not be anticipated at time its development introduction, sotrovimab's use immunocompromised individuals who harbor large populations viruses created conditions for eventual demise, as antibody viral led withdrawal due inefficacy later lineages. Despite this, based on observational data, some authorities have continued promote sotrovimab, but lack binding newer strongly argues futility use. The story highlights power modern biomedical science generate novel therapeutics while also providing cautionary tale need devise strategies minimize emergence resistance antibody-based therapeutics.

Language: Английский

Citations

19
COVID-19 therapeutics DOI
Daniele Focosi, Massimo Franchini, Fabrizio Maggi

et al.

Clinical Microbiology Reviews, Journal Year: 2024, Volume and Issue: 37(2)

Published: May 21, 2024

SUMMARYSince the emergence of COVID-19 in 2020, an unprecedented range therapeutic options has been studied and deployed. Healthcare providers have multiple treatment approaches to choose from, but efficacy those often remains controversial or compromised by viral evolution. Uncertainties still persist regarding best therapies for high-risk patients, drug pipeline is suffering fatigue shortage funding. In this article, we review antiviral activity, mechanism action, pharmacokinetics, safety therapies. Additionally, summarize evidence from randomized controlled trials on various antivirals discuss unmet needs which should be addressed.

Language: Английский

Citations

12
The efficacy of antivirals, corticosteroids, and monoclonal antibodies as acute COVID-19 treatments in reducing the incidence of long COVID: a systematic review and meta-analysis DOI

Gangqiang Sun,

Ke Lin, Jingwen Ai

et al.

Clinical Microbiology and Infection, Journal Year: 2024, Volume and Issue: 30(12), P. 1505 - 1513

Published: July 14, 2024

Language: Английский

Citations

9
Safety and Efficacy of Convalescent Plasma Combined with Other Pharmaceutical Agents for Treatment of COVID-19 in Hospitalized Patients: A Systematic Review and Meta-Analysis DOI Creative Commons
Massimo Franchini, Daniele Focosi, Mario Cruciani

et al.

Diseases, Journal Year: 2024, Volume and Issue: 12(3), P. 41 - 41

Published: Feb. 21, 2024

Plasma collected from people recovered COVID-19 (COVID-19 convalescent plasma, CCP) was the first antibody-based therapy employed to fight pandemic. CCP was, however, often in combination with other drugs, such as antiviral remdesivir and glucocorticoids. The possible effect of interaction has never been investigated systematically. To assess safety efficacy combined agents for treatment patients hospitalized COVID-19, a systematic literature search using appropriate Medical Subject Heading (MeSH) terms performed through PubMed, EMBASE, Cochrane central, medRxiv bioRxiv. main outcomes considered were mortality treatments versus alone. This review carried out accordance methodology including risk bias assessment grading quality evidence. Measure ratio (RR) together 95% confidence intervals (CIs). A total 11 studies (8 randomized controlled trials [RCTs] 3 observational) included review, 4 6 corticosteroids, all involving patients. One RCT reported information on both steroids use CCP. associated significantly reduced death (RR 0.74; CI 0.56–0.97; p = 0.03; moderate certainty evidence), while did not modify 0.72; 0.34–1.51; 0.38; very low evidence). Not enough data retrieved form analysis. current evidence suggests potential beneficial plus compared alone No significant clinical found between steroids.

Language: Английский

Citations

8
Convalescent plasma and predictors of mortality among hospitalized patients with COVID-19: a systematic review and meta-analysis DOI
Massimo Franchini, Mario Cruciani, Carlo Mengoli

et al.

Clinical Microbiology and Infection, Journal Year: 2024, Volume and Issue: 30(12), P. 1514 - 1522

Published: July 26, 2024

Language: Английский

Citations

8
Estimates of actual and potential lives saved in the United States from the use of COVID-19 convalescent plasma DOI Creative Commons
Quigly Dragotakes, Patrick W. Johnson,

Matthew R. Buras

et al.

Proceedings of the National Academy of Sciences, Journal Year: 2024, Volume and Issue: 121(41)

Published: Oct. 1, 2024

In the Spring of 2020, United States America (USA) deployed COVID-19 convalescent plasma (CCP) to treat hospitalized patients. Over 500,000 patients were treated with CCP during first year pandemic. this study, we estimated number actual inpatient lives saved by treatment in based on weekly use, national mortality data, and reduction data from meta-analyses randomized controlled trials real-world data. We also estimate potential if had been for 100% or used 15 75% outpatients. Depending assumptions modeled stratified analyses, that between 16,476 66,296 lives. The ideal use might have as many 234,869 prevented 1,136,133 hospitalizations. deployment was a successful strategy ameliorating impact pandemic USA. This experience has important implications future infectious disease emergencies.

Language: Английский

Citations

6
Estimates of Actual and Potential Lives Saved in the United States from the use of COVID-19 Convalescent Plasma DOI Creative Commons
Quigly Dragotakes, Patrick W. Johnson,

Matthew R. Buras

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 18, 2024

Abstract In the Spring of 2020, United States America (USA) deployed COVID-19 convalescent plasma (CCP) to treat hospitalized patients. Over 500,000 patients were treated with CCP during first year pandemic. this study, estimated number actual inpatient lives saved by treatment in USA based upon weekly use, national mortality data, and reduction data from meta-analyses randomized controlled trials real-world data. We also estimate potential if had been for 100% or used 15% 75% outpatients. Depending on assumptions modeled stratified analyses, was have between 16,476 66,296 lives. The ideal use might as many 234.869 while preventing 1,136,133 hospitalizations. deployment a successful strategy ameliorating impact pandemic USA. This experience has important implications future infectious disease emergencies. Significance statement When struck population lacked immunity, no validated therapies available, high. authorized historical evidence (CP) efficacy findings nationwide registry suggesting that it reduced mortality. However, decision controversial because not clinical trials. we leveraged combined show tens thousands provides powerful basis consider CP

Language: Английский

Citations

4
COVID-19 convalescent plasma in immunocompromised COVID-19 patients: more certainty and clarity are added to a complex evidence base DOI
Hyunah Yoon, Liise-anne Pirofski

EBioMedicine, Journal Year: 2025, Volume and Issue: 114, P. 105654 - 105654

Published: March 18, 2025

Language: Английский

Citations

0
Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review DOI Creative Commons
Massimo Franchini, Daniele Focosi

Life, Journal Year: 2024, Volume and Issue: 14(2), P. 214 - 214

Published: Feb. 1, 2024

Since late 2019, the new SARS-CoV-2 virus belonging to Coronaviridae family has been responsible for COVID-19 pandemic, a severe acute respiratory syndrome. Several antiviral therapies, mostly derived from previous epidemics, were initially repurposed fight this not rarely life-threatening illness. Among them, however, only specific antibody-based therapy available against infection during first year of pandemic was represented by convalescent plasma (CCP). CCP, collected recovered individuals, contains high levels polyclonal antibodies different subclasses able neutralize infection. Tens randomized controlled trials have conducted last three years evaluate safety and clinical efficacy CCP in both hospitalized ambulatory patients, whose main results will be summarized narrative review. In addition, we present current knowledge on development anti-SARS-CoV-2 hyperimmune immunoglobulins.

Language: Английский

Citations

3