Use of convalescent plasma in COVID-19

At the present time, there are no specific therapeutic options or vaccine for coronavirus disease 2019 (COVID-19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The convalescent plasma option is attractive given its precedents in the context of previous pandemics, its rapid availability in areas where the epidemic is active, and its well-known biosecurity profile. There is emerging evidence that proposes the effectiveness of the use of passive immunity through convalescent plasma transfusion, which would exert its effect through different mechanisms of action (neutralization, antibody-mediated cytotoxicity, complement activation, immunomodulation). Globally, the use of convalescent plasma is approved in patients with severe disease criteria or high risk of complication. The available results of international and local experiences demonstrate an adequate biosecurity profile of the use of convalescent plasma with a rate of serious adverse events related to the intervention of less than 1%. So far, the evidence for the efficacy of the intervention is limited to no more than 6 case series, highlighting the need for early administration, close monitoring of outcome variables, and communication of more robust series with greater methodological strength. In our country, several groups are making collaborative and/or metacentric efforts, which will help us to clarify the relevance of this intervention in a still complex panorama of an epidemic that is its highest point without specific tools for its treatment.