Convalescent plasma therapy in patients with COVID-19

Abstract

Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6− 10 days, 11− 15 days) (p=0.001). Conclusion: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.

A single center cohort of 40 severe COVID-19 patients who were treated with convalescent plasma

“…Our results were also comparable with a recent publication of Altuntas et.al, in which they have concluded that, CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients in a Turkish patient cohort [11].…”

Convalescent plasma (CP) therapy in patients with COVID-19

“…We congratulate the authors for conducting a retrospective cohort study of all severe and critically ill COVID-19 patients based on electronic records of the Turkish Ministry of Health. The study included all 888 patients with the exposure (CP transfusion) and a subsample of those unexposed (n = 888), matched to cases on potential confounders including age, gender, comorbidity, and the antiviral treatments used [4]. Having a comparable control group was the main asset of the study design, however, information was missing on: 1) the total number of severe and critically ill patients (target population); 2) total number of eligibles with matched characteristics and whether a representative sampling strategy was used for reaching the final "unexposed" group.…”

“…Anti-SARS-CoV-2 antibody-containing CP was found to be significantly and negatively associated with the length of intensive care unit stay, need for mechanic ventilation and need for vasopressor state, yet the case-fatality rate (CFR) was not significantly lower (24.7 % vs. 27.7 %). We wonder whether the non-significant effect of CP on CFR could be explained, at least partially, by "confounding by indication" [6], as a result of prescribing CP to patients based on physicians' expectation of a worse outcome in these patients due to factors other than those matched on (Table 1) [4], such as levels of infection-related biomarkers or inflammatory cytokines. It is also of concern, whether the use of steroids and/or anticoagulants was similar in patients across the groups.…”

“…It could be likely that the care standards might be different across hospitals using CP. Such a variation might have confounded the associations studied with potential outcomes presented in Table 2 [4].…”

“…Self-reporting of the onset of symptoms is prone to information (recall/awareness) bias [7], thus, we assume that authors presented Tables 3 and 4 together [4]. Both tables suggest that effect of CP is more prominent on severity of disease rather than its effect on fatality.…”