Convalescent plasma transfusion shows promise in COVID-19

  • Shen C & al.
  • JAMA
  • 27 Mar 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Preliminary findings demonstrate improved clinical status in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) receiving convalescent plasma containing neutralizing antibodies.
  • Small clinical trials are underway in the United States and China. 
  • Related editorial details logistical considerations should the approach prove efficacious.

Why this matters

  • Previous studies suggest potential utility of convalescent plasma in treating infections.
  • Same-day collection, transfusion may help preserve natural activity of plasma.

Key results

  • 5 patients, ages 36-73 years, 2 women.
  • 4/5, no preexisting medical conditions.
  • All received methylprednisolone, antivirals pretransfusion, and were mechanically ventilated.
  • Viral load became negative 1-12 days postinfusion.
  • Sequential Organ Failure Assessment scores declined from 2-10 (range) preinfusion to 1-4 at 12 days postinfusion.
  • Pao2/Fio2 ratio improved in 4/5 patients 7 days postinfusion (range, 206-290), increasing substantially (range, 284-366) on day 12.
  • Body temperature declined to normal at 3 days postinfusion. 
  • Computed tomography: pulmonary lesion improvement seen at day 3 in 1 patient, gradual resolution seen in 3 patients.
  • Immunoglobulin G and M titers increased time-dependently.
  • ARDS resolution at day 12 in 4.
  • 3 patients were weaned from mechanical ventilation 2-9 days postinfusion.
  • At report publication, 3/5 were discharged; remaining 2 were stable at day 37 posttransfusion.

Study design

  • Case series, Shenzhen, China.
  • Funding: National Science and Technology Major Project.

Limitations

  • Inability to measure correlation between administration timing, outcomes.