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Published on: January 31, 2025
Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study
Sean T H Liu1,2, Hung-Mo Lin3, Ian Baine4
1Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Convalescent plasma therapy showed potential effectiveness in treating severe COVID-19 patients. This study found improved survival and reduced oxygen requirement worsening in plasma recipients compared to controls.
Area of Science:
- Infectious Diseases
- Immunology
- Hematology
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents a significant global health challenge with limited therapeutic options.
- Convalescent plasma, rich in virus-specific antibodies from recovered individuals, is explored as a potential early-stage treatment.
- Antibodies in convalescent plasma may offer an immediate antiviral effect, crucial while adaptive immunity develops.
Purpose of the Study:
- To evaluate the effectiveness of convalescent plasma transfusion in patients with severe or life-threatening COVID-19.
- To compare clinical outcomes, including oxygen requirements and survival, between COVID-19 patients receiving convalescent plasma and propensity score-matched controls.
Main Methods:
- A retrospective, propensity score-matched case-control study was conducted.
- The study included 39 patients with severe or life-threatening COVID-19 treated with convalescent plasma.
- Outcomes were compared with a control group of similar patients who did not receive convalescent plasma.
Main Results:
- A statistically significant reduction in the worsening of oxygen requirements was observed in convalescent plasma recipients by day 14 (OR, 0.86; P=.025).
- Convalescent plasma transfusion was associated with improved survival rates in severe COVID-19 patients (HR, 0.34; P=.027).
- The study demonstrated a potential benefit of convalescent plasma in managing severe COVID-19.
Conclusions:
- Convalescent plasma therapy appears to be a potentially effective treatment for severe COVID-19.
- Further investigation through adequately powered, randomized controlled trials is essential to confirm these findings.
- Convalescent plasma serves as a critical interim therapeutic strategy during emerging infectious disease outbreaks.
Abstract:
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments1. Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. These antibodies, when transfused into patients infected with SARS-CoV-2, are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses2,3. Virus-specific antibodies from recovered persons are often the first available therapy for an emerging infectious disease, a stopgap treatment while new antivirals and vaccines are being developed1,2. This retrospective, propensity score-matched case-control study assessed the effectiveness of convalescent plasma therapy in 39 patients with severe or life-threatening COVID-19 at The Mount Sinai Hospital in New York City. Oxygen requirements on day 14 after transfusion worsened in 17.9% of plasma recipients versus 28.2% of propensity score-matched controls who were hospitalized with COVID-19 (adjusted odds ratio (OR), 0.86; 95% confidence interval (CI), 0.75-0.98; chi-square test P value = 0.025). Survival also improved in plasma recipients (adjusted hazard ratio (HR), 0.34; 95% CI, 0.13-0.89; chi-square test P = 0.027). Convalescent plasma is potentially effective against COVID-19, but adequately powered, randomized controlled trials are needed.
