Transfus Apher Sci
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This review on COVID-19 immunotherapy enables a comparative analysis of the short-list of currently approved major vaccines. These include the Pfizer and Moderna first mRNA vaccines under FDA purview and the Oxford/AstraZeneca simian adenovirus-vectored vaccine (under UK-MHPRA guidance), all produced in record time, being safe and effective. The Pfizer and Moderna double dose vaccines have the clear edge in treatment efficacy, being in the 90% range compared to AstraZeneca in the average 70%. ⋯ This is due to the failure to standardize the composition of the plasma derived component, ambiguous clinical indications for use in human subjects, and inconsistent timing of administration in the course of the infection. Known T-cell lymphopenia, which is attendant to progressive viral infection and immune driven inflammation, may be a quantitative surrogate biological marker as to when to start treatment. This is not only for initiating plasmapheresis-based therapeutics but also the judicious selection of ancillary pharmaceuticals, ie. monoclonal antibodies, recombinant proteins and anti-viral drugs.