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Multicenter Study
. 2024 Apr;96(4):e29603.
doi: 10.1002/jmv.29603.

Convalescent plasma transfusion for immunocompromised viremic patients with COVID-19: A retrospective multicenter study

Marjolaine Destremau  1 , Hélène Chaussade  1 , Victor Hemar  1 , Mathilde Beguet  2 , Pantxika Bellecave  3 , Elodie Blanchard  4 , Amaury Barret  5 , Gaelle Laboure  6 , Claire Vasco-Moynet  7 , Flore Lacassin  8 , Eloïse Morisse  9 , Claire Aguilar  10 , Xavier Lafarge  2   11 , Marie-Edith Lafon  3 , Fabrice Bonnet  1   12 , Nahéma Issa  13 , Fabrice Camou  13
Affiliations
Multicenter Study

Convalescent plasma transfusion for immunocompromised viremic patients with COVID-19: A retrospective multicenter study

Marjolaine Destremau et al. J Med Virol. 2024 Apr.

Abstract

This study aims to assess the safety, virological, and clinical outcomes of convalescent plasma transfusion (CPT) in immunocompromised patients hospitalized for coronavirus disease 2019 (COVID-19). We conducted a retrospective multicenter cohort study that included all immunosuppressed patients with COVID-19 and RNAemia from May 2020 to March 2023 treated with CPT. We included 81 patients with hematological malignancies (HM), transplants, or autoimmune diseases (69% treated with anti-CD20). Sixty patients (74%) were vaccinated, and 14 had pre-CPT serology >264 BAU/mL. The median delay between symptom onset and CPT was 23 days [13-31]. At D7 post-CPT, plasma PCR was negative in 43/64 patients (67.2%), and serology became positive in 25/30 patients (82%). Post-CPT positive serology was associated with RNAemia negativity (p < 0.001). The overall mortality rate at D28 was 26%, being higher in patients with non-B-cell HM (62%) than with B-cell HM (25%) or with no HM (11%) (p = 0.02). Patients receiving anti-CD20 without chemotherapy had the lowest mortality rate (8%). Positive RNAemia at D7 was associated with mortality at D28 in univariate analysis (HR: 3.05 [1.14-8.19]). Eight patients had adverse events, two of which were severe but transient. Our findings suggest that CPT can abolish RNAemia and ameliorate the clinical course in immunocompromised patients with COVID-19.

Keywords: SARS coronavirus; combination therapy; disease control; infection; virus classification.

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References

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