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Clinical question: What is the evidence for ACE-I and ARB impact on infection?
What is the status of / data from using antibodies from recovered covid patients?
Contributors: Ritika Prasad, Thanh Tran, Natalie Oberhauser-Lim
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Authors (First three authors last name, separated by periods, then date. Eg. e.g. Matthay.Aldrich.Gotts.3.20.20)TitleLanguageKey Points (a couple sentences describing what question they addressed, what they did, what they concluded)Number of patients in series, if applicableCitationAbstractPublication URL
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Chen. Xiong. Bao.2.27.20
Convalescent plasma as a potential therapy for COVID-19
EnglishSummarizes clincal studies using of convalescent antibodies in SARS, Ebola, MERS, 2009 H1N1, 1918 Spanish flu. Many of these studies described using convalescent antibodies as last resort and had good outcomes such as decreased mortality and decreased length of hospitalization. Proposes that clinical tries be done in COVID-19 patients.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30141-9/fulltext
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Casadevall.Pirofski.3.13.2020
The convalescent sera option for containing COVID-19
EnglishDiscusses historical precedents in other viruses like SARS, explores potential mechanisms of action and discusses risks and benefits (both known and theoretical) of using convalescent antibodies. Talks about practical aspects of deploying a strategy of using convalescent antibodies.
https://www.jci.org/articles/view/138003
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Cunningham.Goh.Koh.3.16.2020
Treatment of COVID-19: Old tricks for new challenges
English Discussed the feasibility and potential risks of convalescent
plasma therapy. Conclude that this therapy is helpful in short
terms until definitive treatments are found.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076992/
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Duan.Liu.Li.3.16.2020The feasibility of convalescent plasma therapy in
severe COVID-19 patients: a pilot study		English prior to peer review. Clinical report of convalescent plasma
therapy for COVID-19. One dose 200 mL convalescent plasma
transfer into pts as an addition to maximal supportive care and
antiviral agents. 5 out of 10 cases show rapid increased level
of antibodies post CP transfusion. clinical sx disappeared or
largely improved within 1-3 days. Chest CT shows reduction of
pulmonary lesions. needs further investigations in larger trials.
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https://www.medrxiv.org/content/10.1101/2020.03.16.20036145v1
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Mair-Jenkins.Saavedra-Campos.Baillie.7.16.2014
The Effecticeness of Convalescent Plasma and Hyperimmune Immunoglobulin for the treatment of Severe Acute Respiratory Infections of VIral Etiology: A Systematic Review and Exploratory Meta-analysis English 32 studies of SARS coronavirus infection and severe influenza, Meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy, also showed few adverse effects. Included SARS studies were noted to be of medium to high risk of bias
https://academic.oup.com/jid/article/211/1/80/799341
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Zhang.Liu.2.13.2020
Potential interventions for novel coronavirus in China:
A systematic review
English summary of potentials interventions for COVID-19. Suggest
convalescent plasma should be implemented if its available
https://www.ncbi.nlm.nih.gov/pubmed/32052466
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Wang.Li.Drabek.03.12.2020
A human monoclonal antibody blocking SARS-CoV2 Infection
English Describes the human 47D11 monocolonal antibody that neutralizes SARS-CoV and SARS-CoV-2. It targets conserved core structure of the S1B binding domain. Binds to cells expressing full-length spike proteins of SARS-CoV/-2. Suggests it has potential for precention or treatment of COVID-19.
https://www.biorxiv.org/content/10.1101/2020.03.11.987958v1.abstract
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Status of using
Convalescent
Plasma/Institutions thinking about using it		FDA.3.24.2020Investigational COVID-19 Convalescent
Plasma - Emergency INDs		English FDA now allows tx of life-threatening COVID019 cases using
convalescent plasma. Only as an emergency clearance and
applies only on a case-by-case basis.
https://www.fda.gov/vaccines-blood-biologics/investigational-new-drug-ind-or-device-exemption-ide-process-cber/investigational-covid-19-convalescent-plasma-emergency-inds
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Xinhua Net 2.28.2020 (news report)China puts 245 COVID-19 patients on convalescent plasma therapyEnglish According to news report, per Chinese health officials, China has treated 245 patients with convalescent plasma and 91 cases have shown improvement. Per report, the plamsa was safe and effective. China has established a task force to expand its convalesccent sera operations for COVID-19.245
http://www.xinhuanet.com/english/2020-02/28/c_138828177.htm
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The San Diego Union Tribune 3.23.2020 (news report)
San Diego scientists looking for COVID-19 survivors whose blood might help fight the virusEnglish Scripps Research and UC San Diego have partnered to look for antibodies in the blood of COVID-19 survivors, say they could isolate antibodies in days, determine effectiveness in days to weeks, but would take months to produce enough to treat large numbers of people. Overall view this as a good option until vaccine is developed
https://www-sandiegouniontribune-com.cdn.ampproject.org/c/s/www.sandiegouniontribune.com/news/science/story/2020-03-23/dennis-burton?_amp=true&fbclid=IwAR1T8mF5rTGwtuIduRyESmPDSc4zbjFYy7NC-JkcvhDbo0Ukk4jJnnAkGZU
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Washington University School of Medicine in St Louis Website 3.23.2020Possible COVID-19 treatment: transfusion of antibodies from recovered patients' blood English Note success in Spanish Flu and SARS patients. Say it is a good option because it is much faster than drug development. Need to determine antibody levels in blood of recovered patients and how much to give to ill patients. Filed with FDA for IND on 3/18/2020, if approved "plan to move rapidly to a clinical trial" but do not give any specific timeline
https://medicine.wustl.edu/news/possible-covid-19-treatment-transfusion-of-antibodies-from-recovered-patients-blood/
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VUMC Reporter 03.23.2020Researchers developing potential coronavirus antibody therapies English Vanderbilt Vaccine Center teaming up with "academic, government and corporate partners" to develop antibody based treatments. Have already ID'ed thousands of antibodies, analyzing ability to inhibit virus. Goal to prepare for human clinical trials by this summer.
https://news.vumc.org/2020/03/23/researchers-developing-potential-coronavirus-antibody-therapies/
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Johns Hopkins Hub 03.13.2020Antibodies from COVID-19 survivors could be used to treat patients, protect those at riskEnglish Plan to ask for blood donations from recovered patients. Says it woudl be as safe as a blood transfusion. Says JH could become the IND center in the US for this treatment. Thinks this treatment could be "deployed within a couple of weeks since it relies on standard blood-banking practices" and doesn't require research or development
https://hub.jhu.edu/2020/03/13/covid-19-antibody-sera-arturo-casadevall/
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Mount Sinai 03.23.2020Mount Sinai Developing an "End-to-End" Diagnostics Solution for COVID-19 That Incorporates Diagnossi, Treatment Selection, and Monitoring of Disease CourseEnglish Using High-throughput automated molecular assay. Testing hundreds of patients/day for SARS-CoV-2. Developed ELISA test for antibodies - get idea of number who have been infected, ID those with immunity, ID donors of antibody rich blood. Sharing specimens with New York State Wadsworth Laboratory as well. Did not specify when ab treatment trials could start
https://www.mountsinai.org/about/newsroom/2020/mount-sinai-developing-an-end-to-end-diagnostics-solution-for-covid-19-that-incorporates-diagnosis-treatment-selection-and-monitoring-of-disease-course-pr
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Regeneron 03.17.2020Regeneron announces important advances in novel COVID-19 antibody programEnglish Says they've ID'ed hundreds of virus-neutralizing antibodies, plan to start large-scale manufacturing of "novel multi-antibody cocktail" by mid-April with potential for clincial trials by early summer. Working with US Health & Human Services' Biomedical Advanced Research and Defense Authority to increase capacity. Company has also started phase 2/3 clinical trial of sarilumab (IL-6 inhibtor) for COVID-19 patients
https://investor.regeneron.com/news-releases/news-release-details/regeneron-announces-important-advances-novel-covid-19-antibody
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Nature (news article) 03.24.2020How blood from coronavirus survivors might save lives English Mount Sinai and Albert Einstein College of Medicine both working on plasma as a treatment. FDA announced it will allow emerency use of plasma, so could start treatments as early as next week at these two hospitals. Also hoping use will be extended for precentatitve treatment for high risk individuals (health care providers). 3 protocols submitted to FDA: 1) infuse at early stage and hope to see reduction in critical care need, 2) enroll severe cases, 3) explore as preventative measure for close contacts. Multiple trials done in China but results not yet released but report that prelim results show decrease in circulating virus without improvement of disease, possible treatment given too late to be effective
https://www.nature.com/articles/d41586-020-00895-8
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Takeda 03.04.2020Takeda Initiates Development of a Plasma-Derived Therapy for COVID-19English Takeda is developing an anti-SARS-CoV-2 polyclonal hyperimmune globulin for treatment of "high risk" individuals
https://www.takeda.com/newsroom/newsreleases/2020/takeda-initiates-development-of-a-plasma-derived-therapy-for-covid-19/
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