COVID-19: Can plasma donation really help those who have recovered?

COVID-19: Can plasma donation really help those who have recovered?

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COVID-19: Not yet sufficient evidence on plasma therapy

In numerous clinics, COVID-19 sufferers are treated with the blood plasma of recovered corona patients. However, according to a new study, sufficient evidence for this treatment has so far been lacking.

Despite intensive research in numerous scientific institutes around the world, there is still no effective therapy for coronavirus disease (COVID-19). Therefore, blood plasma is used in some cases from people who have already survived SARS-CoV-2 infection. But does this treatment really help?

Antibodies in the blood plasma of recovered people

According to a recent release from the Cochrane research network, people who have recovered from COVID-19 have antibodies to the SARS-CoV-2 coronavirus in their blood plasma that play an important role in acquired immunity to the disease.

For this reason, plasma from a blood donation from recovered patients, which contains such antibodies, could possibly be used to treat acute cases of COVID-19 sufferers.

According to the information, either cell-free blood plasma (“convalescent plasma”) is used directly or a so-called hyperimmune serum with a particularly high concentration of antibodies is made from such plasma donations.

This principle of plasma therapy was discovered by the German immunologist Emil von Behring at the end of the 19th century and has since been successfully used against a number of infectious diseases.

These treatments (given by drip or injection) are generally well tolerated, but undesirable effects can also occur.

Few completed studies

The authors of this "Cochrane Rapid Review" wanted to find out whether such plasma therapy with plasma or antibodies from recovered COVID-19 patients is an effective treatment for people with COVID-19 and to what extent it causes undesirable effects.

To this end, the specialists systematically searched important medical databases for clinical studies on the treatment with convalescent plasma or hyperimmune serum for patients with COVID-19.

As explained in the communication, Cochrane Rapid Reviews like this are created in an accelerated process, which is intended to ensure the best possible balance between speed and methodical accuracy in the case of particularly urgent questions.

However, the extensive search only yielded eight completed studies (all so-called case series) with a total of 32 participants. The informative value was not only severely limited due to the small number of participants.

In none of these studies were participants randomly divided into different treatment groups - such randomized studies usually provide the most trustworthy evidence.

In addition, none of the case series included a comparison group of people treated without convalescent plasma - so these were not controlled studies. Finally, the participants received various other treatments in addition to the plasma therapy, which made it even more difficult to compare the study results.

No serious statements are possible yet

For these reasons, the authors had to consistently classify the trustworthiness of the evidence as "very low" according to the established "GRADE" rating scheme.

This means that based on the studies that have been completed to date, no serious statements can be made about the effectiveness and risks of plasma therapy against COVID-19.

Even if all study participants survived the often short follow-up phase and 15 of them were even able to leave the clinic, at first glance the authors believe that this positive result can just as well be explained by the natural course of the disease or other treatments, like with the use of convalescent plasma.

"In summary, the information from the studies available at the end of April 2020 means that we are still very uncertain whether the use of convalescent plasma will help patients with COVID-19 and how safe this therapy is," said co-author Nicole Skoetz, who leads the Cochrane network responsible for the review “Cochrane Cancer” at the University Hospital Cologne.

“Despite an extensive search, we could only include evidence of very low trustworthiness from small, uncontrolled studies in which the participants received a number of other treatments in addition to plasma. In addition, these studies used inconsistent endpoints, which makes it difficult to compare the results, ”explains the expert.

"For all these reasons, we cannot currently distinguish whether a patient's recovery was due to the treatment or the natural course of the disease."

Effectiveness not refuted

However, this lack of good evidence does not mean that the effectiveness of plasma therapy against COVID-19 would be refuted.

And according to Vanessa Piechotta, research assistant in Skoetz ’Cologne working group and other co-author of the review, there is definitely reason to hope that the large gaps in knowledge could soon be closed.

“Research in this area is in full swing. We have identified about 50 ongoing studies, 22 of which are randomized studies with high informative value, ”says the researcher.

“16 of these studies are expected to be completed later this year. Therefore, we will update our overview work as a so-called 'Living Systematic Review' monthly so that it always reflects the latest available evidence. "(Ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Cochrane Germany: "Living" Cochrane Rapid Review: Not yet sufficient evidence on plasma therapy against COVID-19, (accessed: May 23, 2020), Cochrane Germany
  • Sarah J Valk, Vanessa Piechotta, Khai Li Chai, Carolyn Doree, Ina Monsef, Erica M Wood, Abigail Lamikanra, Catherine Kimber, Zoe McQuilten, Cynthia So-Osman, Lise J Estcourt, Nicole Skoetz: Convalescent plasma or hyperimmune immunoglobulin for people with COVID ‐ 19: a rapid review; in: Cochrane Database of Systematic Reviews, (published: 14.05.2020), Cochrane Database of Systematic Reviews

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