Treatment of Coronavirus Disease 2019 Patients with Convalescent Plasma Reveals a Signal of Significantly Decreased Mortality

Salazar, Eric; Christensen, Paul; Graviss, Edward A.; Nguyen, Duc T.; Castillo, Brian; Chen, Jian; Lopez, Bevin Valdez; Eagar, Todd N.; Xin, Yi; Zhao, Picheng; Rogers, James V.; Shehabeldin, Ahmed; Joseph, David; Leveque, Christopher; Olsen, Randall J.; Bernard, David W.; Gollihar, Jimmy; Musser, James M.

doi:10.1016/j.ajpath.2020.08.001

Cited by 211 publications

(241 citation statements)

References 43 publications

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“…Additionally, the comparison of the results between the patients who received plasma in the first seven days from the onset of the disease and those who received plasma more than seven days from the onset of the disease showed differences on the clinical scale after 21 and 28 days, and in the duration of hospitalization. Data from the United States shows that plasma is most effective if used in the first three days of hospitalization [ 13 , 14 ]. In our study, we divided the groups into >7 days and >7 days.…”

Section: Discussionmentioning

confidence: 99%

Convalescent Plasma Transfusion for the Treatment of COVID-19—Experience from Poland: A Multicenter Study

Moniuszko

Czupryna

Zarębska-Michaluk

et al. 2020

JCM

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Because the optimal treatment for COVID-19 is still unknown, it is important to explore every potential way of improving the chances of survival for COVID-19 patients. The aim of the study was to analyze the effectiveness of convalescent plasma on COVID-19 patients. The study population consisted of 78 patients diagnosed with COVID-19, selected from the SARSTer national database, who received convalescent plasma. The impact on clinical and laboratory parameters was assessed. A clinical improvement was observed in 62 (79%) patients, and 10 (13%) patients died from COVID-19. No side effects of the convalescent plasma treatment were observed. When plasma was administered earlier than 7 days from diagnosis, the total hospitalization time was shorter (p < 0.05). Plasma efficacy was inferior to remdesivir in endpoints such as the necessity and duration of oxygen therapy, the duration of hospitalization, and mortality rate, and inferior to other drugs in the case of the duration of hospitalization and the necessity of constant oxygen therapy, but comparable in most other measured endpoints. A comparison of a 30-day mortality rate in patients who received plasma and remdesivir (4/25, 16%) and who received only plasma (6/53, 11%) showed no significant difference. Convalescent plasma efficacy is inferior to remdesivir when treating COVID-19 patients but the addition of remdesivir to plasma does not improve the treatment effectiveness. In most endpoints, plasma was comparable to other treatment options. In our opinion, convalescent plasma may be used as a supportive treatment in COVID-19 patients because of the low frequency of adverse effects and availability, but must be given as early from the diagnosis as possible.

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Section: Discussionmentioning

confidence: 99%

Convalescent Plasma Transfusion for the Treatment of COVID-19—Experience from Poland: A Multicenter Study

Moniuszko

Czupryna

Zarębska-Michaluk

et al. 2020

JCM

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“…These efforts require a detailed understanding of immune correlates of protection, formation of immune memory, and durability of these responses. Additionally, infusion of plasma derived from COVID-19 recovered individuals is also being explored as a treatment strategy (12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Characterization of neutralizing versus binding antibodies and memory B cells in COVID-19 recovered individuals from India

Nayak¹,

Gottimukkala²,

Kumar³

et al. 2020

Preprint

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India is one of the countries most affected by the recent COVID-19 pandemic. Characterization of humoral responses to SARS-CoV-2 infection, including immunoglobulin isotype usage, neutralizing activity and memory B cell generation, is necessary to provide critical insights on the formation of immune memory in Indian subjects. In this study, we evaluated SARS-CoV-2 receptor-binding domain (RBD)-specific IgG, IgM, and IgA antibody responses, neutralization of live virus, and RBD-specific memory B cell responses in pre-pandemic healthy versus convalescent COVID-19 individuals from India. We observed substantial heterogeneity in the formation of humoral and B cell memory post COVID-19 recovery. While a vast majority (38/42, 90.47%) of COVID-19 recovered individuals developed SARS-CoV-2 RBD-specific IgG responses, only half of them had appreciable neutralizing antibody titers. RBD-specific IgG titers correlated with these neutralizing antibody titers as well as with RBD-specific memory B cell frequencies. In contrast, IgG titers measured against SARS-CoV-2 whole virus preparation, which includes responses to additional viral proteins besides RBD, did not show robust correlation. Our results suggest that assessing RBD-specific IgG titers can serve as a surrogate assay to determine the neutralizing antibody response. These observations have timely implications for identifying potential plasma therapy donors based on RBD-specific IgG in resource-limited settings where routine performance of neutralization assays remains a challenge.ImportanceOur study provides an understanding of SARS-CoV-2-specific neutralizing antibodies, binding antibodies and memory B cells in COVID-19 convalescent subjects from India. Our study highlights that PCR-confirmed convalescent COVID-19 individuals develop SARS-CoV-2 RBD-specific IgG antibodies, which correlate strongly with their neutralizing antibody titers. RBD-specific IgG titers, thus, can serve as a valuable surrogate measurement for neutralizing antibody responses. These finding have timely significance for selection of appropriate individuals as donors for plasma intervention strategies, as well as determining vaccine efficacy.

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“…Convalescent plasma utilization has an acceptable safety profile and its administration constitutes a feasible approach to implement during a pandemic, even in low-resource settings. In COVID-19, it might reduce viral burden, improve clinical status, and decrease mortality [10][11][12]. On March 24, 2020, the Food and Drug Administration of the United States launched an Expanded Access Program to collect convalescent plasma donated by individuals who had recovered from COVID-19, and on August 23 approved emergency use [13].…”

Section: Resultsmentioning

confidence: 99%

Effect of Convalescent Plasma on Mortality in Patients With Covid-19 Pneumonia

Salazar

González

Regairaz

et al. 2020

Preprint

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Background Convalescent plasma, widely utilized in viral infections that induce neutralizing antibodies, has been proposed for COVID-19, and preliminary evidence shows that it might have beneficial effect. Our objective was to compare epidemiological characteristics and outcomes between patients who received convalescent plasma for COVID-19 and those who did not, admitted to hospitals in Buenos Aires Province, Argentina, throughout the pandemic. Methods This is a multicenter, retrospective cohort study of 2-month duration beginning on June 1, 2020, including unselected, consecutive adult patients with diagnosed COVID-19, admitted to 215 hospitals with pneumonia. Epidemiological and clinical variables were registered in the Provincial Hospital Bed Management System. Convalescent plasma was supplied as part of a centralized, expanded access program. Results We analyzed 3,529 patients with pneumonia, predominantly male, aged 62±17, with arterial hypertension and diabetes as main comorbidities; 51.4% were admitted to the ward, 27.1% to the Intensive Care Unit (ICU), and 21.7% to the ICU with mechanical ventilation requirement (ICU-MV). 28-day mortality was 34.9%; and was 26.3%, 30.1% and 61.4% for ward, ICU and ICU-MV patients. Convalescent plasma was administered to 868 patients (24.6%); their 28-day mortality was significantly lower (25.5% vs. 38.0%, p<0.001). No major adverse effects occurred. Logistic regression analysis identified age, ICU admission with and without MV requirement, diabetes and preexistent cardiovascular disease as independent predictors of 28-day mortality, whereas convalescent plasma administration acted as a protective factor. Conclusions Our study suggests that the administration of convalescent plasma in COVID-19 pneumonia admitted to the hospital might be associated with decreased mortality.

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Treatment of Coronavirus Disease 2019 Patients with Convalescent Plasma Reveals a Signal of Significantly Decreased Mortality

Cited by 211 publications

References 43 publications

Convalescent Plasma Transfusion for the Treatment of COVID-19—Experience from Poland: A Multicenter Study

Convalescent Plasma Transfusion for the Treatment of COVID-19—Experience from Poland: A Multicenter Study

Characterization of neutralizing versus binding antibodies and memory B cells in COVID-19 recovered individuals from India

Effect of Convalescent Plasma on Mortality in Patients With Covid-19 Pneumonia

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