Izna Najam Syed, Nazia Shamim, Ataf Shumail, Syed Muhammad Hussain Zaidi, Umair Tahir
Introduction: The novel coronavirus-2 (SARS-CoV-2) is responsible for the COVID-19 pandemic and to-date, has affected more than 200 countries and over 13 million people worldwide with an excess of 550,000 deaths since its emergence in December 2019. Although several treatment approaches are under scientific scrutiny, there is no definitive treatment for SARS-CoV-2 because of a lack of hard evidence. One of the treatment modalities under consideration is convalescent plasma (CP) therapy, a historical therapeutic tool that has been used repeatedly to treat several infections successfully. Herein we discussed the mechanism of CP therapy's mechanism, in addition to pertinent clinical aspects of the therapy, its potential adverse effects, and recent scientific evidence favoring CP therapy. Methodology: The aim of this systematic review was to determine the efficacy of CP therapy in COVID-19 in addition to highlighting the various facets of CP therapy. Multiple search engines including, but not exclusive of, PubMed, Google scholar and science direct were used to look for relevant primary studies using pertinent mesh terms. 54 research articles were identified that focused on the mechanism of action, various clinical considerations, adverse effects of CP therapy, as well as evidence in favor of the use of CP therapy in COVID-19. Articles published between 1990 and 2020 were included in this systematic review as per the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Results: In the light of these findings, CP therapy appears to be a potentially safe and effective therapeutic modality particularly in the treatment of critically ill patients with COVID-19. In spite of the encouraging outcome of CP therapy in COVID-19 in small nonrandomized clinical trials, larger randomized clinical trials are required before this treatment modality can be employed in the treatment of COVID-19 on a large scale. However, it can be used empirically in critically ill COVID-19 patients as a life-saving measure due to the unavailability of other proven therapeutic modalities. Clinical judgement and risk vs benefit assessment should be done when using CP therapy on an empirical basis. Conclusion: CP therapy appears to be an effective therapeutic approach for the treatment of emerging pathogens, particularly in the absence of definitive antiviral agents or vaccines. The potential antiviral and immunomodulatory eﬀects of CP should be evaluated in COVID-19. Keywords: COVID 19, convalescent plasma, passive antibody therapy, SARS-CoV-2, COVID-19 serum therapy, Serotherapy for SARS-CoV-2.