Convalescent Plasma for Patients With Severe Coronavirus Disease 2019 (COVID-19): A Matched Cohort Study. (10th October 2020)

• Record Type: Journal Article
• Authors: Rogers, Ralph; Shehadeh, Fadi; Mylona, Evangelia K; Rich, Josiah; Neill, Marguerite; Touzard-Romo, Francine; Geffert, Sara; Larkin, Jerome; Bailey, Jeffrey A; Lu, Shaolei; Sweeney, Joseph; Mylonakis, Eleftherios
• Is Part Of: Clinical infectious diseases. Volume 73:Number 1(2021)
• Page Start: e208
• Page End: e214
• Publication Date: 2020-10-10
• Subjects: convalescent plasma -- COVID-19 -- SARS-CoV-2 -- efficacy; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1548
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: The efficacy of convalescent plasma (CP) for the treatment of coronavirus disease 2019 (COVID-19) remains unclear. Methods: In a matched cohort analysis of hospitalized patients with severe COVID-19, the impact of CP treatment on in-hospital mortality was evaluated using univariate and multivariate Cox proportional-hazards models, and the impact of CP treatment on time to hospital discharge was assessed using a stratified log-rank analysis. Results: In total, 64 patients who received CP a median of 7 days after symptom onset were compared to a matched control group of 177 patients. The incidence of in-hospital mortality was 12.5% and 15.8% in the CP and control groups, respectively ( P = .52). There was no significant difference in the risk of in-hospital mortality between the 2 groups (adjusted hazard ratio [aHR] 0.93, 95% confidence interval [CI] .39–2.20). The overall rate of hospital discharge was not significantly different between the 2 groups (rate ratio [RR] 1.28, 95% CI .91–1.81), although there was a significantly increased rate of hospital discharge among patients 65-years-old or greater who received CP (RR 1.86, 95% CI 1.03–3.36). There was a greater than expected frequency of transfusion reactions in the CP group (2.8% reaction rate observed per unit transfused). Conclusions: We did not demonstrate a significant difference in risk of mortality or rate of hospital discharge between the CP and control groups. There was a signal for improved outcomes among the elderly, and further adequately powered randomized studies should target this subgroup when assessing the efficacy of CP treatment. Abstract : Treatment of severe COVID-19 with convalescent plasma was not associated with a significantly different risk of in-hospital mortality or rate of hospital discharge as compared to standard care. Elderly patients may be most likely to benefit from convalescent plasma.