4.7 Article

Convalescent plasma for the treatment of patients with severe coronavirus disease 2019: A preliminary report

Journal

JOURNAL OF MEDICAL VIROLOGY
Volume 93, Issue 3, Pages 1678-1686

Publisher

WILEY
DOI: 10.1002/jmv.26537

Keywords

convalescent plasma; coronavirus; COVID-19; passive immunotherapy; SARS-CoV-2

Categories

Funding

  1. Qatar National Library

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A study compared critically ill COVID-19 patients who received standard care with those who also received convalescent plasma therapy, finding no clinical benefits associated with convalescent plasma. There were no significant differences in 28-day mortality rates and viral clearance rates between the two groups, and randomized trials are needed to confirm these findings.
Background The role of convalescent plasma therapy for patients with coronavirus disease 2019 (COVID-19) is unclear. Methods We retrospectively compared outcomes in a cohort of critical COVID-19 patients who received standard care (SC Group) and those who, in addition, received convalescent plasma (CP Group). Results In total, 40 patients were included in each group. The median patient age was 53.5 years (interquartile range [IQR] 42-60.5), and the majority of patients required invasive ventilation (69, 86.2%). Plasma was harvested from donors after a median of 37 days (IQR 31-46) from the first positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) result and 26 days (IQR 21-32) after documented viral clearance; it was administered after a median of 10 days (IQR 9-10) from the onset of symptoms and 2.5 days (IQR 2-4) from admission to intensive care unit. The primary endpoint of improvement in respiratory support status within 28 days was achieved in 26 patients (65%) in the SC Group and 31 patients (77.5%) in the CP Group (p = .32). The 28-day all-cause mortality (12.5% vs. 2.5%;p = .22) and viral clearance (65% vs. 55%;p = .49) were not significantly different between the two groups. Convalescent plasma was not significantly associated with the primary endpoint (adjusted hazard ratio 0.87; 95% confidence interval 0.51-1.49;p = .62). Adverse events were balanced between the two study groups. Conclusion In severe COVID-19, convalescent plasma therapy was not associated with clinical benefits. Randomized trials are required to confirm our findings.

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