4.6 Article

Early mortality benefit with COVID-19 convalescent plasma: a matched control study

Journal

BRITISH JOURNAL OF HAEMATOLOGY
Volume 192, Issue 4, Pages 706-713

Publisher

WILEY
DOI: 10.1111/bjh.17272

Keywords

COVID-19; convalescent plasma; mortality; transfusion; oxygenation

Categories

Funding

  1. US Department of Health and Human Services (HHS), Biomedical Advanced Research and Development Authority (BARDA) grant [75A50120C00096]
  2. National Center for Advancing Translational Sciences (NCATS) [UL1TR002377]
  3. Schwab Charitable Fund
  4. United Health Group
  5. National Basketball Association (NBA)
  6. Millennium Pharmaceuticals
  7. Octopharma Octapharma USA, Inc
  8. Mayo Clinic

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The study demonstrated that patients with COVID-19 who received CCP had a decreased risk of death at 7 and 14 days, but not 28 days after transfusion, compared to matched controls.
Convalescent plasma can provide passive immunity during viral outbreaks, but the benefit is uncertain for the treatment of novel coronavirus disease 2019 (COVID-19). Our goal is to assess the efficacy of COVID-19 convalescent plasma (CCP). In all, 526 hospitalized patients with laboratory-confirmed SARS-CoV-2 at an academic health system were analyzed. Among them, 263 patients received CCP and were compared to 263 matched controls with standard treatment. The primary outcome was 28-day mortality with a subanalysis at 7 and 14 days. No statistical difference in 28-day mortality was seen in CCP cases (25.5%) compared to controls (27%, P = 0.06). Seven-day mortality was statistically better for CCP cases (9.1%) than controls (19.8%, P < 0.001) and continued at 14 days (14.8% vs. 23.6%, P = 0.01). After 72 h, CCP transfusion resulted in transitioning from nasal cannula to room air (median 4 days vs. 1 day, P = 0.02). The length of stay was longer in CCP cases than controls (14.3 days vs. 11.4 days, P < 0.001). Patients with COVID-19 who received CCP had a decreased risk of death at 7 and 14 days, but not 28 days after transfusion. To date, this is the largest study demonstrating a mortality benefit for the use of CCP in patients with COVID-19 compared to matched controls.

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