COVID-19 convalescent plasma: significant promise in pilot study, 8 trials registered

  • Duan K & et al
  • Proceedings of the National Academy of Sciences
  • 6 Apr 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • A single 200 mL convalescent plasma (CP) transfusion dose safely improved neutralizing antibodies in some severely ill COVID-19 patients in a small pilot study. 
  • All patients showed clinical improvement.
  • Findings in unrelated case series reinforce safety, benefit.

Why this matters

  • 8 newly registered clinical trials in Israel, Iran, Colombia, the United States, and China will explore CP safety and efficacy.
  • Recruitment has begun in 2.

Key results

  • 10 patients in pilot; median age, 52.5 (interquartile range, 45.0-59.5) years.
  • Median time from symptom onset to hospitalization: 6 (2.5-8.5) days. 
  • Median time to CP transfusion: 16.5 (11.0-19.3) days.
  • 100% (10/10) experienced improved or resolved symptoms (fever, cough, shortness of breath, chest pain) 1-3 days posttransfusion.
  • Degree of pulmonary lesion absorption was variable.
  • 7/10 showed improved lymphocyte counts: medians, 0.65×109/L before vs 0.76×109/L after transfusion.
  • Overall decline in inflammatory and/or liver dysfunction markers observed.
  • Increased oxygen saturation seen: median, 93.00% pretransfusion vs 96.00% posttransfusion.
  • 5 had posttransfusion increase in antibody titers.
  • SARS-CoV-2 RNA was undetectable in 3 patients at day 2 posttransfusion, 3 more at day 3, and 1 more at day 6; the other 3 were negative pretransfusion.
  • Patient status in this pilot compared with an historical control group (all P<.001>
    • Discharged: 3 vs 0.
    • Much improved: 7 vs 1. 
    • Deaths: 0 vs 3.
    • Stabilized: 10 vs 6.
  • No serious adverse or safety events.

Study design

  • Pilot study exploring feasibility of 200 mL CP transfusion in 10 severely ill COVID-19 patients in China.
  • Funding: Ministry of Science and Technology, China.

Limitations

  • Unexplored confounders.
  • Optimal antibodies concentration, treatment schedule unclear.