Convalescent Plasma the Experience and Journey from Blockbuster to Incognito: A Single Centre Experience

Abstract

BACKGROUND: Convalescent plasma has been used to provide passive immunotherapy to patients with Covid-19 with a high level of safety. Very few efficacy studies were available, and COVID being a relatively new disease, exact therapeutic role was unclear. This observational study on impact of Covid convalescent plasma (CCP) on clinical outcomes attempts to evaluate the effectiveness of convalescent Covid 19 plasma therapy in treatment of Covid 19 patients at the tertiary care center in the Uttarakhand state of India. METHODS: CCP was collected by plasmapheresis/ whole blood from willing Covid recovered donors who underwent pre-donation testing including ABO and RhD grouping, mandatory blood screening tests for HIV, HBV, HCV, syphilis and Malaria, Haemoglobin estimation, Covid IgG assay. Hospitalized patients with severe Covid-19 pneumonia who received these CCP units were followed up and outcome (Recovery/death) was observed. RESULTS: A total of 63 patients who received CCP were included in the study. Out of total, 13 (20.7 %) were females and 50 (79.3 %) males and their age ranged from 24 to 80 years with median age of 53 years. The period between the start of symptoms and hospitalization ranged from 1 to 14 days with average duration of 4.7 days. Symptoms on presentation included Fever 53/63 (84.1 %), Tachypnoea 60/63 (95.2 %) and Cough 42/63 (66.7 %). Among these patients, 22/63 (34.9 %) were on non-invasive ventilation (NIV), 6/63 (9.5 %) on non-rebreather mask (NRBM) and 32/63 (50.8 %) were on Ventilator support. The infused convalescent plasma had a Mean IgG value of 57.3 AU with a range of (10-142 AU). A total of 37 (58.7 %) patients were lost to Covid-19 infection and 26 (41.3 %) were discharged from hospital in healthy state. CONCLUSION: The use of convalescent plasma in addition to standard treatment in our study on patients with severe pneumonia due to Covid-19 did not demonstrate reduced mortality of Covid 19 patients amidst numerous variables. The results showed that the use of convalescent plasma as a treatment option in the present conditions needs a serious re-evaluation. Studies on a strictly defined recipient group and transfusion of CCP units, with adequate antibody titer and/or neutralization activity must be analyzed for future works.