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El plasma de convalecientes como un tratamiento potencial en pacientes con COVID-19
Resumen
Introducción: El plasma de convalecientes es una inmunoterapia pasiva que se ha usado para el tratamiento y prevención de muchas enfermedades infecciosas por más de un siglo. Dada la falta de tratamiento específico para el nuevo coronavirus SARS-CoV-2, el plasma de convalecientes es una alternativa terapéutica potencial contra la COVID-19.
Objetivo: Realizar una revisión del empleo del plasma de convalecientes como alternativa terapéutica a la COVID-19.
Desarrollo: Se empleó la estrategia de búsqueda del tema; consultando las bases de datos Pubmed, SciELO, Lilacs, Cochrane Library y Web of Science. El plasma de convalecientes ha mostrado efectividad en el tratamiento de varias enfermedades virales. Así, la evidencia sobre su uso en los pacientes con COVID-19 es escasa, aunque se han obtenido resultados alentadores, pero no concluyentes por falta de un número mayor ensayos clínicos. Al mismo tiempo, Cuba incluye en sus protocolos de actuación contra la COVID-19 este tratamiento.
Conclusiones: Esta alternativa resulta una herramienta inmunoterapéutica en los pacientes con la COVID-19, ya que mejora el estado clínico y disminuir la tasa de letalidad. Sin embargo, se necesitan más ensayos clínicos controlados y aleatorizados que afirmen su efectividad y seguridad.
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Referencias
Beigel JH, Aga E, Elie-Turenne MC, Cho J, Tebas P, Clark CL, et al. Anti-influenza immune plasma for the treatment of patients with severe influenza A: a randomised, double-blind, phase 3 trial. Lancet Respir Med. 2019;7(11):941-50. DOI: 10.1016/S2213-2600(19)30199-7
Langhi Junior DM, De Santis GC, Bordin JO. COVID-19 convalescent plasma transfusion. Hematol Transfus Cell Ther. 2020;42 (2):113-5. DOI: 10.1016/j.htct.2020.04.003
Zhang L, Liu Y. Potential interventions for novel coronavirus in China: a systematic review. J Med Virol. 2020;92:479-90. DOI: 10.1002/jmv.25707
Casadevall A, Pirofski L. The convalescent sera option for containing COVID-19. J Clin Invest. 2020;130(4):1545-8. DOI: 10.1172/JCI138003
Zhang J, Xie B, Hashimoto K. Current status of potential therapeutic candidates for the COVID-19 crisis. Brain, Behavior, and Immunity. 2020;87:59-73. DOI: 10.1016/j.bbi.2020.04.046
Vitón-Castillo AA, Rodríguez-Venegas EC. COVID-19. Alternativas Terapéuticas. 16 de Abril. 2020 [acceso: 15/05/2020]; 59(276):e921. Disponible en: http://www.rev16deabril.sld.cu/index.php/16_4/article/view/921
Duan K, Liu B, Li C, Zhange H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. PNAS Latest Articles. 2020;117(17):9490-6. DOI: 10.1073/pnas.2004168117
Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400. DOI: 10.1016/S1473-3099(20)30141-9
Cuba. Ministerio de Salud Pública. Protocolo de Actuación Nacional para la COVID-19 versión 1.4. La Habana: Ministerio de Salud Pública; mayo de 2020. [acceso: 17/06/2020]. Disponible en: https://files.sld.cu/editorhome/files/2020/05/MINSAP_Protocolo-de-Actuaci%C3%B3n-Nacional-para-la-COVID-19_versi%C3%B3n-1.4_mayo-2020.pdf
Società Italiana di Malattie Infettive e Tropicali. Linee guida sulla gestione terapéutica e di supporto per pazienti con infezione da coronavirus COVID-19. Sezione Regione Lombardia; 2020. [acceso: 26/06/2020]. Disponible en: https://www.fvcalabria.unicz.it/COVID-19/LINEE-GUIDA/linee-guida-SIMIT-marzo-2020.pdf
Hinweise zu Erkennung. Diagnosis and Treatment of patients with COVID-19. Robert Koch Institute; 2020. [acceso: 26/06/2020]. Disponible en: http://www.rki.de/DE/Content/Komissionen/Stakob/Stellungnahmen/Stellungnahme-Covid-19_Therapie_Diagnose.pdf?_blob=publicationFile
España. Gobierno de España. Ministerio de Sanidad. Documento técnico: Manejo clínico del COVID-19: atención hospitalaria. Madrid: Ministerio de Sanidad; 2020. [acceso: 26/06/2020]. Disponible en: http://www.mscbs.gob.es/en/profesionales/saludPublica/ccayes/alertasActual/InCov-China/documentos/Protocolo_manejo_clínico_ah_COV-19.pdf
China. National Health Commission & State Administration of Traditional Chinese Medicine Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia. Version 7. Beijing: National Health Commission & State Administration of Traditional Chinese Medicine; marzo de 2020. [acceso: 17/06/2020]. Disponible en: https://www.chinadaily.com.cn/pdf/2020/1.Clinical.Protocols.for.the.Diagnosis.and.Treatment.of.COVID-19.V7.pdf
Cunningham AC, Goh HP, Koh D. Treatment of COVID-19: old tricks for new challenges. Crit Care. 2020;24:91. DOI: 10.1186/s13054-020-2818-6
Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14 (1):72-3. PMID: 32074550
Chen Z, Hu J, Zhang Z, Jiang S, Han S, Yan D, et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. [Preprint]. Epidemiology. 2020. [acceso: 17/06/2020]. Disponible en: https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v1.full.pdf
Mahévas M, Tran VT, Roumier M, Chabrol A, Paule R, Guillaud C. Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data. BMJ. 2020;369:m1844. DOI: 10.1136/bmj.m1844
World Health Organization (WHO). Novel coronavirus 2019. Situation reports. 2020. [actualizado: 20/06/2020; acceso: 20/06/2020]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
Cuba. Ministerio de Salud Pública. Parte del cierre del día 19 de junio a las 12 de la noche. La Habana: Ministerio de Salud Pública; 2020. [actualizado: 20/06/2020; acceso: 20/06/2020]. Disponible en: www.salud.msp.gob.cu/parte-de-cierre-del-día-19-de-junio-a-las-12-de-la-noche/?doing_wp_cron=1611422377.4410760402679443359375
World Health Organization (WHO). Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003; 2003. [actualizado: 31/12/2003; acceso: 30/05/2020]. Disponible: https://www.who.int/csr/sars/country/table2004_04_21/en/
Marano G, Vaglio S, Pupella S, Facco G, Catalano L, Liumbruno GM, et al. Convalescent plasma: new evidence for an old therapeutic tool? Blood Transfus. 2016;14:152-7. DOI: 10.2450/2015.0131-15
Lai CC, Shi TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. DOI: 10.1016/j.ijantimicag.2020.105924
Kraft CS, Hewlett AL, Koepsell S, Winkler AM, Kratochvil CJ, Larson LA, et al. Nebraska Biocontainment Unit and the Emory Serious Communicable Diseases Unit. The Use of TKM-100802 and Convalescent Plasma in 2 Patients with Ebola Virus Disease in the United States. Clin Infect Dis. 2015;61(4):496-502. DOI: 10.1093/cid/civ334
Beigel JH, Voell J, Kumar P, Raviprakash K, Wu H, Jiao JA, et al. Safety and tolerability of a novel, polyclonal human anti-MERS coronavirus antibody produced from transchromosomic cattle: a phase 1 randomised, double-blind, single-dose-escalation study. Lancet Infect Dis. 2018;18 (4):410-8. DOI: 10.1016/S1473-3099(18)30002-1
Robbins JB, Schneerson R, Szu SC. Perspective: hypothesis: serum IgG antibody is sufficient to confer protection against infectious diseases by inactivating the inoculum. J Infect Dis. 1995;171(6):1387-98. DOI: 10.1093/infdis/171.6.1387
Casadevall A, Pirofski LA. Antibody-mediated regulation of cellular immunity and the inflammatory response. Trends Immunol. 2003;24(9):474-8. DOI: 10.1016/S1471-4906(03)00228-X
Behring E, Kitasato S. Ueber das Zustandekommen der Diphtherie-Immunitat und der Tetanus-Immunitat bei thieren. Deutsche medizinsche Wochenschrift. 1890;16:1113-4. En: Milestones in Microbiology: 1556 to 1940. Brock TD, editor. Washington: ASM Press; 1998. p. 138.
Simon J. Emil Behring’s medical culture: from disinfection to serotherapy. Med Hist. 2007;51:201-18. PMCID: PMC1871706
Luke TC, Casadevall A, Watowich SJ, Hoffman S, Beigel JH, Burgess TH. Hark back: passive immunotherapy for influenza and other serious infections. Crit Care Med. 2010 [acceso: 15/05/2020]; 38:e66-73. Disponible en: https://journals.lww.com/ccmjournal/Fulltext/2010/04001/Hark_back__Passive_immunotherapy_for_influenza_and.9.aspx
Stinebaugh BJ, Schloeder FX, Johnson KM, Mackenzie RB, Entwisle G, De Alba E. Bolivian hemorrhagic fever. A report of four cases. Am J Med. 1996;40:217-30. DOI: 10.1016/0002-9343(66)90103-3
Ruggiero HA, Perez Isquierdo F, Milani HA, Barri A, Val A, Maglio F, et al. Treatment of Argentine hemorrhagic fever with convalescent’s plasma 4433 cases. Presse Med. 1986;15:2239-42. PMID: 2949253
Frame JD, Verbrugge GP, Gill RG, Pinneo L. The use of Lassa fever convalescent plasma in Nigeria. Trans R Soc Trop Med Hyg. 1984;78:319-24. DOI: 10.1016/0035-9203(84)90107-X
Hung IF, To KK, Lee CK, Lee KL, Chan K, Yan WW, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis. 2011;52:447-56. DOI: 10.1093/cid/ciq106
Hung IF, To KK, Lee CK, Lee KL, Yan WW, Chan K, et al. Hyperimmune IV immunoglobulin treatment a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A (H1N1) infection. Chest. 2013;144:464-73. DOI: 10.1378/chest.12-2907
Cheng Y, Wong R, Soo YOY, Wong WS, Lee CK, Ng MHL, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis 2015;24:44-6. DOI: 10.1007/s10096-004-1271-9
Luke TC, Kilbane EM, Jackson JL, Hoffman SL. Meta-analysis convalescent blood products for Spanish influenza pneumonia: a future H5N1 treatment? Ann Intern Med. 2006;145:599-609. DOI: 10.7326/0003-4819-145-8-200610170-00139
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Limet WS, et al. Convalescent Plasma Study Group, The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: A systematic review and exploratory metaanalysis. J. Infect. Dis. 2015;211:80-90. DOI: 10.1093/infdis/jiu396
Beigel JH, Tebas P, Elie-Turenne MC, Bajwa E, Bell TE, Cairns CB, et al. Immune plasma for the treatment of severe influenza: an open-label, multicentre, phase 2 randomised study. Lancet Respir Med. 2017;5:500-11. DOI: 10.1016/s2213-2600(17)30174-1
World Health Organization. Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks; 2015. [acceso: 15/05/2020]. Disponible en: https://apps.who.int/iris/rest/bitstreams/604045/retrieve
Sahr F, Ansumana R, Massaquoi TA, Idriss BR, Sesay FR, Lamin JM, et al. Evaluation of convalescent whole blood for treating Ebola virus disease in Freetown, Sierra Leone. J Infect. 2017;74(3):302-9. DOI: 10.1016/j.jinf.2016.11.009
van Griensven J, Edwards T, de Lamballerie X, Semple MG, Gallian P, Baize S, et al. Ebola-Tx Consortium, Evaluation of convalescent plasma for Ebola virus disease in Guinea. N. Engl. J. Med. 2016;374:33-42. DOI: 10.1056/NEJMoa1511812
Arabi Y, Balkhy H, Hajeer AH. Feasibility, safety, clinical, and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection: a study protocol. Springerplus. 2015;4:709. DOI: 10.1186/s40064-015-1490-9
Rabaan AA, Alahmed SH, Bazzi AM, Alhani HM. A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective. J Med Microbiology. 2017;66:1261-74. DOI: 10.1099/jmm.0.000565
Ahn JY, Sohn Y, Lee SH, Cho Y, Hyun JH, Baek YJ, et al. Use of convalescent plasma therapy in two COVID-19 patients with ARDS in Korea. J Korean Med Sci. 2020;35(14):e149. DOI: 10.3346/jkms.2020.35.e149
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. Forthcoming. 2020 [acceso: 15/05/2020]; 323(16):1582-9. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2763983
Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA. 2020;324(5): 460-70. DOI: 10.1001/jama.2020.10044
Casadevall A, Joyner MJ, Pirofski LA. A Randomized Trial of Convalescent Plasma for COVID-19 – Potentially Hopeful Signals. JAMA. 2020; 324(5): 455-457. DOI: 10.1001/jama.2020.10218
Yoo JH. Convalescent Plasma Therapy for Corona Virus Disease 2019: A Long Way to Go but Worth Trying. J Korean Med Sci. 2020;35(14):e150. DOI: 10.3346/jkms.2020.35.e150
FDA. Investigational covid-19 convalescent plasma-emergency INDs. 2020. [actualizado: 24/3/2020; acceso: 15/05/2020]. Disponible en: https://www.fda.gov/vaccines-blood-biologics/investigational-new-drug-ind-or-device-exemption-ide-process-cber/investigational-covid-19-convalescent-plasmaemergency-inds
Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020;20:1403-35. DOI: 10.1097/CCM.0000000000004363
Soy M, Keser G, Atagunduz P, Tabak F, Atagunduz I, Kayhan S, et al. Cytokine storm in COVID-19: pathogenesis and overview of antiinflammatory agents used in Treatment. Clin Rheumatol 2020;39:2085-94. DOI: 10.1007/s10067-020-05190-5
Halstead SB. Dengue antibody-dependent enhancement: Knowns and unknowns. Microbiol. Spectr. 2015;2(6). DOI: 10.1128/microbiolspec.AID-0022-2014
Wang SF, Tseng SP, Yen CH, Yang JY, Tsao CH, Shen CW, et al. Antibody-dependent SARS coronavirus infection is mediated by antibodies against spike proteins. Biochem. Biophys. Res. Commun. 2015;451:208-14. DOI: 10.1016/j.bbrc.2014.07.090
Crowe JE, Firestone CY, Murphy BR. Passively acquired antibodies suppress humoral but not cell-mediated immunity in mice immunized with live attenuated respiratory syncytial virus vaccines. J Immunol. 2001;167(7):3910-8. DOI: 10.4049/jimmunol.167.7.3910
Mora-Rillo M, Arsuaga M, Ramírez-Olivencia G, de la Calle F, Borobia AM, Sánchez-Seco P, et al. La Paz-Carlos III University Hospital Isolation Unit, Acute Respiratory distress syndrome after convalescent plasma use: Treatment of a patient with Ebola virus disease contracted in Madrid, Spain. Lancet Respir. Med. 2015;3(7):554-62. DOI: 10.1016/S2213-2600(15)00180-0
Menis M, Sridhar G, Selvam N, Ovanesov MV, Divan HA, Liang Y, et al. Hyperimmune globulins and same-day thrombotic adverse events as recorded in a large healthcare database during 2008-2011. Am J Hematol. 2017 [acceso: 15/05/2020]; 88:1035-40. Disponible en: http://doi.wiley.com/10.1002/ajh.23559
Parreiras VC, de Sá Rocha I, Martins AS, de Souza Meira EB, Taniguchi FP. Influence of fresh frozen plasma as a trigger factor for kidney disfunction in cardiovascular surgery. Rev Bras Cir 2012 [acceso: 26/06/2020]; 27(3). DOI: 10.5935/1678-9741.20120069
Cuba. Cronología: Dos meses de la COVID-19 en Cuba. Portal de ciudadano espirituano. 2020. [actualizado: 27/04/2020; acceso: 04/06/2020]. Disponible en: http://www.espirituano.gob.cu/es/sugerencia/4252-cronologia-coronavirus-19-cuba
Roback JD, Guarner J. Convalescent Plasma to Treat COVID-19 Possibilities and Challenges. JAMA. 2020;323(16):1561-2. DOI: 10.1001/jama.2020.4940
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