COVID-19

==== Passive antibodies ====
[[File:Ppat.1008735.g002.png|thumb|Overview of the application and use of [[convalescent plasma]] therapy]]

Transferring purified and concentrated [[Immunoglobulin therapy|antibodies]] produced by the immune systems of those who have recovered from COVID‑19 to people who need them is being investigated as a non-vaccine method of [[Passive immunity|passive immunisation]].<ref name="pmid-32167489">{{#invoke:cite journal || vauthors = Casadevall A, Pirofski LA | title = The convalescent sera option for containing COVID-19 | journal = The Journal of Clinical Investigation | volume = 130 | issue = 4 | pages = 1545–1548 | date = April 2020 | pmid = 32167489 | pmc = 7108922 | doi = 10.1172/JCI138003 }}</ref><ref name=":0">{{#invoke:Cite journal ||last1=Iannizzi |first1=Claire |last2=Chai |first2=Khai Li |last3=Piechotta |first3=Vanessa |last4=Valk |first4=Sarah J. |last5=Kimber |first5=Catherine |last6=Monsef |first6=Ina |last7=Wood |first7=Erica M. |last8=Lamikanra |first8=Abigail A. |last9=Roberts |first9=David J. |last10=McQuilten |first10=Zoe |last11=So-Osman |first11=Cynthia |last12=Jindal |first12=Aikaj |last13=Cryns |first13=Nora |last14=Estcourt |first14=Lise J. |last15=Kreuzberger |first15=Nina |date=2023-05-10 |title=Convalescent plasma for people with COVID-19: a living systematic review |journal=The Cochrane Database of Systematic Reviews |volume=2023 |issue=5 |pages=CD013600 |doi=10.1002/14651858.CD013600.pub6 |issn=1469-493X |pmc=10171886 |pmid=37162745 |pmc-embargo-date=May 10, 2024 }}</ref> [[Neutralisation (immunology)|Viral neutralisation]] is the anticipated [[mechanism of action]] by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralising antibodies.<ref name="Ho-2020">{{#invoke:cite journal || vauthors = Ho M | title = Perspectives on the development of neutralizing antibodies against SARS-CoV-2 | journal = Antibody Therapeutics | volume = 3 | issue = 2 | pages = 109–114 | date = April 2020 | pmid = 32566896 | pmc = 7291920 | doi = 10.1093/abt/tbaa009 | title-link = doi | doi-access = free }}</ref> As of 8{{spaces}}August 2020, eight neutralising antibodies targeting the spike protein of SARS-CoV-2 have entered clinical studies.<ref>{{#invoke:cite journal || vauthors = Yang L, Liu W, Yu X, Wu M, Reichert JM, Ho M | title = COVID-19 antibody therapeutics tracker: a global online database of antibody therapeutics for the prevention and treatment of COVID-19 | journal = Antibody Therapeutics | volume = 3 | issue = 3 | pages = 205–212 | date = July 2020 | pmid = 33215063 | pmc = 7454247 | doi = 10.1093/abt/tbaa020 }}</ref> It has been proposed that selection of broad-neutralising antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID‑19 but also future SARS-related CoV infections.<ref name="Ho-2020" /> Other mechanisms, however, such as [[antibody-dependent cellular cytotoxicity|antibody-dependant cellular cytotoxicity]] or [[phagocytosis]], may be possible.<ref name="pmid-32167489" /> Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.<ref name="pmid-32167489" />

The use of passive antibodies to treat people with active COVID{{nbhyph}}19 is also being studied. This involves the production of [[convalescent serum]], which consists of the liquid portion of the blood from people who recovered from the infection and contains antibodies specific to this virus, which is then administered to active patients.<ref name="pmid-32167489" /> This strategy was tried for SARS with inconclusive results.<ref name="pmid-32167489" /> An updated Cochrane review in May 2023 found high certainty evidence that, for the treatment of people with moderate to severe COVID‑19, convalescent plasma did not reduce mortality or bring about symptom improvement.<ref name=":0" /> There continues to be uncertainty about the safety of convalescent plasma administration to people with COVID‑19 and differing outcomes measured in different studies limits their use in determining efficacy.<ref name=":0" />
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