An Old Therapy, Convalescent Plasma, for Coronavirus Disease-19: Do We Have All the Answer?


  • Ahmad Faried Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; Stem Cell Unit, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; Convalescent Plasma Therapy for COVID-19 Team, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
  • Wahyu Widowati Department of Biology, Faculty of Medicine, Maranatha Christian University, Bandung, West Java, Indonesia
  • Ruswana Anwar Convalescent Plasma Therapy for COVID-19 Team, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
  • Nucki Nursjamsi Hidajat Stem Cell Unit, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
  • Ali Budi Harsono Stem Cell Unit, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
  • Yulius Hermanto Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; Stem Cell Unit, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
  • Alya Mardhotillah Azizah Biomolecular and Biomedical Research Center, Aretha Medika Utama, Bandung, West Java, Indonesia
  • Jenifer Kiem Aviani Biomolecular and Biomedical Research Center, Aretha Medika Utama, Bandung, West Java, Indonesia



Coronavirus disease-19, Severe acute respiratory syndrome-coronavirus-2, Passive immunization, Convalescent plasma therapy


BACKGROUND: Coronavirus (CoV) disease (COVID-19) has become a global health pandemic by early 2020; it has pushed the health-care system to its limit. From the initial estimates, 15% of COVID-19 patients caused by severe acute respiratory CoV 2 syndrome present with severe symptoms and requires hospitalization or even intensive care. There is no specific treatment against COVID-19, particularly for those with severe symptoms. Desperation caused by COVID-19 has driven clinicians to try an alternative therapies with little or even no-evidence previously. Convalescent plasma therapy (CPT) has emerged as a promising COVID-19 therapy.

AIM: We aimed to review current state of convalescent plasma therapy.

METHODS: We summarize the historical CPT, COVID-19 pathology and evaluate potential of CPT for COVID-19; raising the question regarding routinely administrating CPT to the COVID-19 patients, whether it is safe and effective.

RESULTS: From cases in Indonesia and other countries, there is bunch of examples that healthcare workers being negatively stigmatized in case of COVID-19. They lost their rights to have a normal life in this pandemic era. A reasonable basis is found in many literatures to advocate the CPT. Convalescent plasma from COVID-19 patients who had been recovered with high neutralizing antibody titers was reported to be effective on transfusion to other COVID-19 patients.

CONCLUSION: CPT is one good option to treat COVID-19 patients, but it not without risk; many potential candidate treatment that promising in theory but somehow fall apart when translated into clinical study; only time will tell, including our ongoing CPT clinical study.


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Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci USA. 2020;117(17):9490-6. PMid:32253318

World Health Organization. Coronavirus Disease 2019 (COVID- 19) Dashboard; 2020. Available from: [Last accessed on 2020 May 24].

Gugus Tugas Percepatan Penanganan COVID-19, Data Sebaran; 2020. Available from: [Last accessed on 2020 May 24].

Chang L, Yan Y, Wang L. Coronavirus disease 2019: Coronaviruses and blood safety. Transfus Med Rev. 2020;34(2):75-80. PMid:32107119

Worldmeter. COVID-19 Coronavirus Pandemic: Worldmeter; 2020. Available from: [Last accessed on 2020 May 24].

Rokom. Pasien Positif COVID-19 Bertambah 2 Orang. Jakarta: Kementrian Kesehatan Republik Indonesia; 2020. Available from: [Last accessed on 2020 Mar 06].

Pusat Data COVID-19 RSHS, Bandung; 2020. Available from: mei-2020. [Last accessed on 2020 May 22].

Tatalaksana Pasien COVID-19. Perhimpunan Dokter Paru Indonesia; 2020. Available from: [Last accessed on 2020 Apr 10].

Sullivan HC, Roback JD. Convalescent plasma: Therapeutic hope or hopeless strategy in the SARS-CoV-2 pandemic. Transfus Med Rev. 2020;34(3):145-50. PMid:32359788

Rosa SG, Santos WC. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica. 2020;44:e40. PMid:32256547

Monica Th, Triyono T, Harly PR. Penatalaksanaan Terapi Plasma Konvalesen (TPK) Bagi Pasien COVID-19. Indonesia: Tim TPK COVID-19; 2020.

Anudeep TC, Jeyaraman M, Shetty DU, Raj MH, Ajay SS, Somasundaram R, et al. Convalescent plasma as a plausible therapeutic option in nCOVID-19-a review. J Clin Trials. 2020;10:409.

Casadevall A, Pirofski LA. The convalescent sera option for containing COVID-19. J Clin Invest. 2020;130(4):1545-8. PMid:32167489

Zhou B, Zhong N, Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection. N Engl J Med. 2007;357(14):1450-1. PMid:17914053

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(4):447-56. PMid:21248066

Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44-6. PMid:15616839

Ko JH, Seok H, Cho SY, Ha YE, Baek JY, Kim SH, et al. Challenges of convalescent plasma infusion therapy in Middle East respiratory Coronavirus infection: A single centre experience. Antivir Ther. 2018;23(7):617-22. PMid:29923831

Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Napoli RD. Features, Evaluation and Treatment Coronavirus. Treasure Island, FL: Stat Pearls Publishing; 2020.

Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020;83(3):217-20. PMid:32134861

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel Coronavirus in Wuhan, China. Lancet. 2020;395(10233):497-506. PMid:31986264

Cyranoski D. Profile of a killer: The complex biology powering the Coronavirus pandemic. Nature. 2020;581(7806):22-6. PMid:32367025

Korber B, Fischer WM, Gnanakaran S, Yoon H, Theiler J, Abfalterer W, et al. Spike Mutation Pipeline Reveals the Emergence of a More Transmissible form of SARS-CoV-2, bioRxiv; 2020.

Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A novel Coronavirus emerging in China-key questions for impact assessment. N Engl J Med. 2020;382(8):692-4.

Chen J. Pathogenicity and transmissibility of 2019-nCoV-a quick overview and comparison with other emerging viruses. Microbes Infect. 2020;22(2):69-71. PMid:32032682

van Boheemen S, de Graaf M, Lauber C, Bestebroer TM, Raj VS, Zaki AM, et al. Genomic characterization of a newly discovered Coronavirus associated with acute respiratory distress syndrome in humans. mBio. 2012;3(6):e00473-12. PMid:23170002

Raj VS, Mou H, Smits SL, Dekkers DH, Müller MA, Dijkman R, et al. Dipeptidyl peptidase 4 is a functional receptor for the emerging human Coronavirus-EMC. Nature. 2013;495(7440):251-4. PMid:23486063

Perlman S, Netland J. Coronaviruses post-SARS: Update on replication and pathogenesis. Nat Rev Microbiol. 2009;7(6):439- 50. PMid:19430490

Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new Coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9. PMid:32015508

Zhou P, Yang X, Wang X, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new Coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. PMid:32015507

Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel Coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS Coronavirus. J Virol. 2020;94(7):e00127-20. PMid:31996437

de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: Recent insights into emerging Coronaviruses. Nat Rev Microbiol. 2016;14(8):523-34. PMid:27344959

Global Initiative on Sharing Avian Flu Data (GISAID). Genomic Epidemiology of hCoV-19; 2020. Available from: https://www. [Last accessed on 2020 Sep 02].

Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the clinical characteristics of Coronavirus disease 2019 (COVID-19). J Gen Intern Med. 2020;35(5):1545-9. PMid:32133578

Yang Y, Shen C, Li J, Yuan J, Yang M, Wang F, et al. Exuberant Elevation of IP-10, MCP-3 and IL-1ra During SARS-CoV-2 Infection is Associated with Disease Severity and Fatal Outcome, medRxiv; 2020.

Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, et al. Transplantation of ACE2-mesenchymal stem cells improves the outcome of patients with COVID-19 pneumonia. Aging Dis. 2020;11(2):216-28. PMid:32257537

Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348(20):1986-94. PMid:12682352

Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome Coronavirus disease from Saudi Arabia: A descriptive study. Lancet Infect Dis. 2013;13(9):752-61. PMid:23891402

Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli- Berg FM, et al. COVID-19 and the cardiovascular system: Implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666-87. PMid:32352535

Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant. 2020;39(5):405-7. PMid:32362390

Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Lim WS, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: A systematic review and exploratory meta-analysis. J Infect Dis. 2015;211(1):80-90. PMid:25030060

Brown BL, McCullough J. Treatment for emerging viruses: Convalescent plasma and COVID-19. Transfus Apher Sci. 2020;59(3):102790. PMid:32345485

World Health Organization. Use of Convalescent Whole Blood or Plasma Collected from Patients Recovered from Ebola Virus Disease No. WHO/HIS/SDS/2014.8. Geneva: World Health Organization; 2014. p. 1-19.

Davey RT, Fernández-Cruz E, Markowitz N, Pett S, Babiker AG, Wentworth D, et al. Anti-influenza hyperimmune intravenous immunoglobulin for adults with influenza A or B infection (FLU-IVIG): A double-blind, randomised, placebo-controlled trial. Lancet Respir Med. 2019;7(11):951-63. PMid:31582358

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(8):599-609. PMid:16940336

Chen X, Zhao B, Qu Y, Chen Y, Xiong J, Feng Y, et al. Detectable Serum SARS-CoV-2 Viral Load (RNAaemia) is Closely Associated with Drastically Elevated Interleukin 6 (IL-6) Level in Critically Ill COVID-19 Patients, medRxiv; 2020.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62. PMid:32171076

Guo L, Ren L, Yang S, Xiao M, Chang, Yang F, et al. Profiling early humoral response to diagnose novel Coronavirus disease (COVID-19). Clin Infect Dis. 2020;71(15):778-85. PMid:32198501

Long QX, Deng HJ, Chen J, Hu J, Liu BZ, Liao P, et al. Antibody Responses to SARS-CoV-2 in COVID-19 Patients: The Perspective Application of Serological Tests in Clinical Practice, medRxiv; 2020.

Zeng F, Dai C, Cai P, Wang J, Xu L, Li J, et al. A Comparison Study of SARS-CoV-2 IgG Antibody Between Male and Female COVID-19 Patients: A Possible Reason Underlying Different Outcome Between Gender, medRxiv; 2020.

Zhang B, Liu S, Dong Y, Zhang L, Zhong Q, Zou Y, et al. Positive rectal swabs in young patients recovered from Coronavirus disease 2019 (COVID-19). J Infect. 2020;81(2):e49-52. PMid:32335176

Chan KH, Cheng VC, Woo PC, Lau SK, Poon LL, Guan Y, et al. Serological responses in patients with severe acute respiratory syndrome Coronavirus infection and cross-reactivity with human coronaviruses 229E, OC43, and NL63. Clin Diagn Lab Immunol. 2005;12(11):1317-21. PMid:16275947

Focosi D, Tang J, Anderson A, Tuccori M. Convalescent Plasma Therapy for COVID-19: State of the Art, Preprints 2020.

Franchini M, Marano G, Velati C, Pati I, Pupella S, Liumbruno GM. Operational protocol for donation of anti- COVID-19 convalescent plasma in Italy. Vox Sang. 2020. PMid:32324899

Pei S, Yuan X, Zhang ZZ, Yao RR, Xie Y, Shen MM, et al. Convalescent Plasma to Treat COVID-19: Chinese Strategy and Experiences, medRxiv; 2020.

Monica Th, Triyono T, Harly PR. Penatalaksanaan Terapi Plasma Konvalesen Bagi Pasien COVID-19, Tim TPK COVID- 19 Indonesia; 2020.

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. 2020;323(16):1582-9. PMid:32219428

Ye M, Fu D, Ren Y, Wang F, Wang D, Zhang F, et al. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol. 2020. PMid:32293713

Yazer MH. The how’s and why’s of evidence based plasma therapy. Korean J Hematol. 2010;45(3):152-7. PMid:21120202

Leider JP, Brunker PA, Ness PM. Convalescent transfusion for pandemic influenza: Preparing blood banks for a new plasma product? Transfusion. 2010;50(6):1384-98. PMid:20158681

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. PMid:32492084

Gharbharan A, Jordans CC, Geurtsvankessel C. Convalescent Plasma for COVID-19. A Randomized Clinical Trial, medRxiv; 2020.

Joyner MJ, Wright RS, Fairweather D, Senefeld JW, Bruno KA, Klassen SA, et al. Early safety indicators of COVID- 19 convalescent plasma in 5, 000 patients. J Clin Invest. 2020;130(9):4791-7. PMid:32525844

Enzmann MO, Erickson MP, Grindeland CJ, Lopez SM, Hoover SE, Leedahl DD. Treatment and preliminary outcomes of 150 acute care patients with COVID-19 in a rural health system in the Dakotas. Epidemiol Infect. 2020;148:e124. PMid:32605683




How to Cite

Faried A, Widowati W, Anwar R, Hidajat NN, Harsono AB, Hermanto Y, Azizah AM, Aviani JK. An Old Therapy, Convalescent Plasma, for Coronavirus Disease-19: Do We Have All the Answer?. Open Access Maced J Med Sci [Internet]. 2020 Nov. 14 [cited 2021 Dec. 4];8(T1):530-7. Available from:

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