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Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere COVID-19: An

Kelly Cho1,2, Sarah C Keithly3, Katherine E Kurgansky1

  • 1Massachusetts Veterans Epidemiology Research and Information Center, Department of Veterans Affairs Office of Research and Development, Boston, Massachusetts, USA.

The Journal of Infectious Diseases
|June 21, 2021
PubMed

Insights

Early convalescent plasma transfusion did not significantly reduce 30-day mortality in nonsevere COVID-19 patients. This study found no meaningful difference in survival rates between treated and untreated groups.

Area of Science:

  • Infectious Diseases
  • Clinical Trials
  • Public Health

Background:

  • Convalescent plasma transfusion is an investigational therapy for COVID-19.
  • Early intervention may impact patient outcomes in nonsevere COVID-19 cases.

Purpose of the Study:

  • To emulate a target trial using observational data to assess the efficacy of early convalescent plasma transfusion in nonsevere COVID-19 patients.
  • To compare 30-day mortality rates between patients receiving convalescent plasma and those who did not.

Main Methods:

  • Utilized observational data from US veterans admitted to VA facilities between May and November 2020.
  • Emulated a target trial design comparing convalescent plasma initiated within 2 days of eligibility.
  • Employed inverse probability weighting to adjust for confounding factors and estimated mortality using cumulative incidence curves, risk differences, and hazard ratios.

Main Results:

  • Analyzed 11,269 eligible person-trials from 4,755 patients; 402 received convalescent plasma.
  • Observed 40 deaths in the plasma group and 671 in the nonplasma group.
  • Estimated 30-day mortality risk was 6.5% (plasma) vs. 6.2% (nonplasma), with a risk difference of 0.30% and a hazard ratio of 1.04, indicating no significant difference.

Conclusions:

  • Target trial emulation suggests no meaningful difference in 30-day mortality for nonsevere COVID-19 patients treated with convalescent plasma compared to untreated patients.
  • Findings do not support the routine use of early convalescent plasma for nonsevere COVID-19 based on 30-day mortality.
  • Clinical Trials Registration: NCT04545047.
Abstract

Keywords:
COVID-19SARS-CoV-2convalescent plasmacoronavirus

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