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Randomized Controlled Trial

High-Dose Convalescent Plasma for Treatment of Severe COVID-19

Gil C De Santis et al. Emerg Infect Dis. 2022 Mar.

Abstract

To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients with severe COVID-19 who were within 10 days of initial symptom onset were eligible. Patients in the CCP group received 3 daily doses of CCP (600 mL/d) in addition to standard treatment; control patients received standard treatment only. Primary outcomes were death rates at days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days. We enrolled 107 patients: 36 CCP and 71 control. At day 30, death rates were 22% for CCP and 25% for the control group; at day 60, rates were 31% for CCP and 35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between groups. We conclude that high-dose CCP transfused within 10 days of symptom onset provided no benefit for patients with severe COVID-19.

Keywords: 2019 novel coronavirus disease; Brazil; COVID-19; SARS-CoV-2; convalescent plasma; coronavirus disease; neutralizing antibody; passive immunization; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

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Figures

Figure 1
Figure 1
Enrollment and randomization process for study of high-dose CCP for treatment of severe COVID-19, Brazil. COVID-19, coronavirus disease; CCP, COVID-19 convalescent plasma.
Figure 2
Figure 2
Probability of survival after randomization for study of high-dose CCP for treatment of severe COVID-19. COVID-19, coronavirus disease; CCP, COVID-19 convalescent plasma.
Figure 3
Figure 3
Scatter plots of inflammatory biomarker levels among participants in study of high-dose convalescent plasma for treatment of severe COVID-19, Brazil. A) C-reactive protein (CRP); total 80 patients (26 CCP, 54 control) on day 0 and 56 (20 CCP, 36 control) on day 7. B) Interleukin-6 (IL-6); total 39 patients (15 CCP, 24 control) on day 0 and 27 (11 CCP, 16 control) on day 7. Horizontal bars indicate medians. C0, control group day 0; C7, control group day 7; COVID-19, coronavirus disease; CCP, COVID-19 convalescent plasma; NS, not significant; P0, convalescent plasma group day 0; P7, convalescent plasma group day 7.
See this image and copyright information in PMC

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