https://doi.org/10.4081/monaldi.2024.3050
Evaluation of the efficacy of convalescent plasma in moderate to severe COVID-19 during 2020-2021: a retrospective observational study
Submitted: May 5, 2024
Accepted: October 18, 2024
Published: December 20, 2024
Accepted: October 18, 2024
Abstract Views: 410
PDF_EARLY VIEW: 77
SUPPLEMENTARY MATERIAL: 10
SUPPLEMENTARY MATERIAL: 10
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Convalescent plasma therapy (CPT) is one of the treatment modalities used for COVID-19. Initial smaller studies showed the usefulness of CPT in COVID-19, but larger studies showed that it is not effective. This is a retrospective observational study conducted between 1st June 2020 and 31st July 2021 at a tertiary hospital in Noida, India. Our analysis was done on 213 COVID-19 patients, comprising 170 cases who were given convalescent plasma and 43 controls who did not get CPT. Outcomes analyzed were improvement in PaO2:FiO2 ratio (PFR) by day 5 of CPT, 28-day mortality, and level of inflammatory markers. Mean PFR before plasma transfusion was comparable between CPT and control groups (142.11±73.99 vs. 151.11±88.87, p=0.56). There was no significant difference in mean PFR after 5 days of CPT between cases and the control group (187.02±102.34 vs. 160.29±83.39, p=0.206). 28-day mortality was 47.05% in the CPT group and 37.20% in the control group (p=0.246). Mortality amongst the subgroup of patients on invasive mechanical ventilation was 89.74% in cases and 80% in controls (p=0.518). No significant difference was found in levels of serum ferritin, interleukin-6, and C-reactive protein between the two groups. Convalescent plasma does not have a significant effect on day 5 PFR and 28-day mortality. Our study could not find any subgroup of patients who would benefit from CPT. This study reinforces that CPT does not benefit moderate to severe patients with COVID-19.
Libster R, Pérez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe covid-19 in older adults. N Engl J Med 2021;384:610-8.
DOI: https://doi.org/10.1056/NEJMc2104747
Salazar E, Christensen PA, Graviss EA, et al. Significantly decreased mortality in a large cohort of coronavirus disease 2019 [COVID-19] patients transfused early with convalescent plasma containing high-titer anti-severe acute respiratory syndrome coronavirus 2 [SARS-COV-2] spike protein IgG. Am J Pathol 2021;191:90-107.
DOI: https://doi.org/10.1016/j.ajpath.2020.10.008
Joyner MJ, Carter RE, Senefeld JW, et al. Convalescent plasma antibody levels and the risk of death from Covid-19. N Engl J Med 2021;384:1015-27.
DOI: https://doi.org/10.1056/NEJMoa2031893
Agarwal A, Mukherjee A, Kumar G, et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial). BMJ 2020;371:m3939.
DOI: https://doi.org/10.1136/bmj.m3939
RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet 2021;397:2049-59.
DOI: https://doi.org/10.1016/S0140-6736(21)00897-7
Bégin P, Callum J, Jamula E, et al. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nat Med 2021;27:2012-24.
DOI: https://doi.org/10.1038/s41591-021-01488-2
Bloch EM, Shoham S, Casadevall A, et al. Deployment of convalescent plasma for the prevention and treatment of COVID-19. J Clin Invest 2020;130:2757-65.
DOI: https://doi.org/10.1172/JCI138745
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis 2015;211:80-90.
DOI: https://doi.org/10.1093/infdis/jiu396
ICMR. Evidence based advisory to address inappropriate use of convalescent plasma in covid-19 patients. Available from: https://drugscontrol.org/pdf/ICMR_ADVISORY_Convalescent_plasma_17112020.pdf.
Li L, Zhang W, Hu Y, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA 2020;324:460-70.
DOI: https://doi.org/10.1001/jama.2020.12607
Gharbharan A, Jordans CCE, Geurtsvan Kessel C, et al. Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection. Nat Commun 2021;12:3189.
DOI: https://doi.org/10.1038/s41467-021-23469-2
Simonovich VA, Burgos Pratx LD, Scibona P, et al. A randomized trial of convalescent plasma in Covid-19 severe pneumonia. N Engl J Med 2021;384:619-29.
DOI: https://doi.org/10.1056/NEJMoa2031304
Piechotta V, Chai KL, Valk SJ, et al. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev 2020;7:CD013600.
DOI: https://doi.org/10.1002/14651858.CD013600.pub2
Kurtz P, Righy C, Gadelha M, et al. Effect of convalescent plasma in critically ill patients with COVID-19: An observational study. Front Med 2021;8:630982.
DOI: https://doi.org/10.3389/fmed.2021.630982
ICMR. e-Samvaad May 2021.
Government of India. Final G.S.R. 166(E)_Amendment in Part X B & Part XII B pertains to blood center and blood components, drugs and cosmetics act 1940 and rules 1945, amended 11th march 2020. Available from: https://drugscontrol.py.gov.in/sites/default/files/GSR-166-E.pdf.
AJ Padkin, WJ Kinnear. Supplemental oxygen and nasal intermittent positive pressure ventilation. Eur Respir J 1996;9:834-36.
DOI: https://doi.org/10.1183/09031936.96.09040834
Conte G, Cei M, Evangelista I, et al. The meaning of D-dimer value in Covid-19. Clin Appl Thromb Hemost 2021;27:10760296211017668.
DOI: https://doi.org/10.1177/10760296211017668
Artifoni M, Danic G, Gautier G, et al. Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors. J Thromb Thrombolysis 2020;50:211-6.
DOI: https://doi.org/10.1007/s11239-020-02146-z
Duan K, Liu B, Li C, et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A 2020;117:9490-6.
DOI: https://doi.org/10.1073/pnas.2006961117
Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA 2020;323:1582-9.
DOI: https://doi.org/10.1001/jama.2020.4783
Hartman WR, Hess AS, Connor JP. Hospitalized COVID-19 patients treated with convalescent plasma in a mid-size city in the Midwest, Transl Med Commun 2020;5:17.
DOI: https://doi.org/10.1186/s41231-020-00068-9
WHO. Therapeutics and COVID-19. 2021. Available from: https://www.who.int/docs/default-source/coronaviruse/2021.4-lg-therapeutics-and-covid-19-2021-12-07-en.pdf.
Budhiraja S, Dewan A, Ritesh Aggarwal, et al. Effectiveness of convalescent plasma in Indian patients with COVID-19. Blood Cells Mol Dis 2021;88:102548.
DOI: https://doi.org/10.1016/j.bcmd.2021.102548
Camou F, Tinevez C, Mathilde Beguet-Yachine, et al. Feasibility of convalescent plasma therapy in severe COVID-19 patients with persistent SARS-CoV-2 viremia. J Med Virol 2021;93:5594-8.
DOI: https://doi.org/10.1002/jmv.27032
Pouladzadeh M, Safdarian M, Eshghi P, et al. A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm. Intern Emerg Med 2021;16:2181-91.
DOI: https://doi.org/10.1007/s11739-021-02734-8
Zietz M, Zucker J, Tatonetti NP. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun 2020;11:5761.
DOI: https://doi.org/10.1038/s41467-020-19623-x
Agrawal A, Jha T, Gogoi P, et al. Effect of convalescent plasma therapy on mortality in moderate-to-severely Ill COVID-19 patients. Transfus Apher Sci 2022;61:103455.
DOI: https://doi.org/10.1016/j.transci.2022.103455
Altuntas F, Ata N, Tugce Nur Yigenoglu, et al. Convalescent plasma therapy in patients with COVID-19. Transfus Apher Sci 2021;60:102955.
DOI: https://doi.org/10.1016/j.transci.2020.102955
Kournoutou GG, Dinos G. Azithromycin through the Lens of the COVID-19 treatment. Antibiotics 2022;11:1063.
DOI: https://doi.org/10.3390/antibiotics11081063
Hennekens CH, Rane M, Solano J, et al. Updates on hydroxychloroquine in prevention and treatment of COVID-19. Am J Med 2022;135:7-9.
DOI: https://doi.org/10.1016/j.amjmed.2021.07.035
Jabaley CS, Coopersmith CM. Vitamin C for patients with COVID-19: more evidence of lack of efficacy in patients with sepsis. JAMA 2023;330:1739-41.
DOI: https://doi.org/10.1001/jama.2023.18592
RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med 2021;384:693-704.
DOI: https://doi.org/10.1056/NEJMoa2021436
Ethics Approval
The study protocol was approved by the Fortis Hospital Institutional Ethics Committee meeting, held on 6th October 2022, document number- FHIEC/2022/06.How to Cite
Kumar, Sunny, Saurabh Mehra, Mrinal Sircar, Onkar Jha, Rajesh Gupta, Seema Sinha, and Ravneet Kaur. 2024. “Evaluation of the Efficacy of Convalescent Plasma in Moderate to Severe COVID-19 During 2020-2021: A Retrospective Observational Study”. Monaldi Archives for Chest Disease, December. https://doi.org/10.4081/monaldi.2024.3050.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Sonali Mallik, Ananda Datta, Debahuti Mohapatra, Paraskeletal plasmacytoma presenting as a chest wall mass , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Carlo Uran, Through the heart and beyond: a review on ranolazine , Monaldi Archives for Chest Disease: Vol. 92 No. 1 (2022)
You may also start an advanced similarity search for this article.
