WHO Issues Guidance Against Convalescent Plasma for COVID-19

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The World Health Organization has updated its guidelines for COVID-19 treatments against the use of convalescent plasma for all cases of infection. 

In a statement Monday, the WHO said that transfusing blood plasma from a person who has already recovered from the illness should only be applied in a clinical trial setting for COVID-19 patients in severe and critical conditions. However, it does not recommend this line of treatment for any COVID-19 case. 

This is the seventh update of the living guidelines. The organization's latest decision is based on advice from the guidelines development group, an independent panel of experts, who evaluated data from 16 randomized controlled studies on some 16,236 patients who had either non-severe, severe or critical infections. 

"Current evidence shows that convalescent plasma does not improve survival or reduce the need for mechanical ventilation, while it has significant costs. While the evidence that convalescent plasma has no benefit in non-severe patients was certain, it was less so in the case of severe and critically ill patients. So, randomized clinical trials for these subgroups should continue," the WHO said in a news release. 

As of this writing, the living guidelines for COVID-19 recommend using a combination of casirivimab and imdevimab in non-severe cases with high risk for severe disease and in severe and critically-ill patients with seronegative status and of tocilizumab or sarilumab in severe or critical cases. 

It advises against using ivermectin (except in clinical trials), hydroxychloroquine, lopinavir/ritonavir and systemic corticosteroids. Other COVID-19 therapeutics still under review include anticoagulants and colchicine. 

Earlier this year, the U.S. Food and Drug Administration (FDA) also said that convalescent plasma should only be used under emergency situations for hospitalized patients in early progression and those with immune system disorders and who have been hospitalized due to infection. 

"Plasma with low levels of antibodies has not been shown to be helpful in COVID-19," the FDA said in a statement. 

"The use of low titer COVID-19 convalescent plasma is no longer authorized under the EUA as additional data from clinical trials, including randomized, controlled trials, have not shown evidence to demonstrate that low titer convalescent plasma may be effective in the treatment of hospitalized patients with COVID-19," added the FDA.

WHO guidelines on the use of medications to prevent, not treat, COVID-19 are detailed in a document titled "WHO Living Guideline: Drugs to Prevent COVID-19," while rules on the clinical management of patients are in another report titled "COVID-19 Clinical Management: Living Guideline."

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