Treatment with convalescent plasma for COVID-19 patients in Wuhan, China

Abstract

The discovery of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the outbreak of coronavirus disease 2019 (COVID-19) are causing public health emergencies. A handful pieces of literature have summarized its clinical and radiologic features, whereas therapies for COVID-19 are rather limited. To evaluate the efficacy of convalescent plasma therapy in COVID-19 patients, we did this timely descriptive study. Six laboratory-confirmed COVID-19 patients were enrolled and received the transfusion of ABO-compatible convalescent plasma. The efficacy of this intervention was determined by the alleviation of symptoms, changes in radiologic abnormalities and laboratory tests. No obvious adverse effect observed during the treatment. Transfusion of convalescent plasma led to a resolution of ground-glass opacities and consolidation in patients #1, #2, #3, #4, and #6. In patients #1 and #5 who presented with SARS-CoV-2 in throat swab, convalescent plasma therapy elicited an elimination of the virus. Serologic analysis indicated an immediate increase in anti-SARS-CoV-2 antibody titers in patients #2 and #3, but not in patient #1. This study indicates that convalescent plasma therapy is effective and specific for COVID-19. This intervention has a special significance for eliminating SARS-CoV-2 and is believed to be a promising state-of-the-art therapy during COVID-19 pandemic crisis.

Keywords: COVID-19; SARS-CoV-2; convalescent plasma therapy.

Figure 1

A diagram summarizes the treatment and major laboratory findings of patient #1. This patient had persistent positive results for throat tests. Transfusion of convalescent plasma was given on 10th, 13th, and 16th March, respectively. Representative chest CT images on 29th February and 4th March suggest the absorption of patchy scattered GGOs in the right lung (indicated by white arrows). Repeated throat swab test indicates clearance of residual SARS‐CoV‐2. CT, computed tomography; GGO, ground glass opacity; PCR, polymerase chain reaction

Figure 2

A diagram summarizes the treatment and major laboratory findings of patient #2. The patient manifested as consolidation involving multiple subsegmental lobes. The patient received convalescent plasma on 5th and 9th March. The dynamic evolution of consolidation was presented by chest CT on 22nd February, 5th, 11th, and 18th March, respectively. CT, computed tomography; PCR, polymerase chain reaction

Figure 3

A diagram summarizes the treatment and major laboratory findings of patient #3. Chest CT on 21st February showed consolidation, multiple GGOs, reticular opacities with fibrosis streak. The patient received three cycles of convalescent plasma therapy and this intervention led to the alleviation of symptoms, as well as a gradually radiologic improvement. A septal line appeared in left down lobe after indicated treatment. CT, computed tomography; GGO, ground glass opacity; PCR, polymerase chain reaction

Figure 4

A diagram summarizes the treatment and major laboratory findings of patient #4. The 63‐year‐old female patient concurrent with Sjögren syndrome had multiple GGOs with partial consolidation and fibrosis streak at admission. After indicated treatment, she presented as GGOs with partial consolidation. Transfusion of convalescent plasma was done on 10th March, and repeated chest CT showed a slight decrease in the density of GGOs. CT, computed tomography; GGO, ground glass opacity; PCR, polymerase chain reaction

Figure 5

A diagram summarizes the treatment and major laboratory findings of patient #5. The patient was defined as postdischarge SARS‐CoV‐2‐positive COVID‐19, and treated with convalescent plasma on 13th March. Consecutive SARS‐CoV‐2 throat swab tests indicated an elimination of residual SARS‐CoV‐2.CT, computed tomography; GGO, ground glass opacity; PCR, polymerase chain reaction

Figure 6

A diagram summarizes the treatment and major laboratory findings of patient #6. The radiologic feature of this patient is extensive GGOs. The convalescent plasma was given on 18th March, and repeated chest CT showed a remarkable resolution of GGOs after the intervention. CT, computed tomography; GGO, ground glass opacity; PCR, polymerase chain reaction