Convalescent plasma associates with reduced mortality and improved clinical trajectory in patients hospitalized with...

Area of Science:

• Infectious Diseases
• Hematology
• Epidemiology

Background:

• Convalescent plasma (CP) was an early investigational treatment for coronavirus disease 2019 (COVID-19).
• Evidence for CP's effectiveness has been inconclusive, resulting in conflicting clinical recommendations.
• A comparative effectiveness study was needed to evaluate CP's impact on COVID-19 mortality.

Purpose of the Study:

• To conduct a comparative effectiveness study of convalescent plasma (CP) for all-cause, in-hospital mortality in COVID-19 patients.
• To analyze the association between CP administration and patient mortality risk.
• To investigate the impact of timing and serology levels of CP on patient outcomes.

Main Methods:

• A retrospective, multicenter cohort study involving 44,770 patients hospitalized with COVID-19.
• Utilized electronic health records from 176 HCA Healthcare-affiliated hospitals.
• Employed coarsened exact matching (1:k) to create comparable groups of 3,774 CP recipients and 10,687 controls, controlling for clinical and demographic factors.

Main Results:

• Convalescent plasma was significantly associated with a lower risk of in-hospital mortality (adjusted hazard ratio [aHR] = 0.71; P < 0.001).
• Patients receiving CP showed faster recovery trajectories.
• CP administered within 3 days of admission demonstrated a significantly lower mortality risk (aHR = 0.53; P < 0.001), while treatment between 4-7 days did not show a significant benefit.

Conclusions:

• This large-scale, real-world evidence study demonstrates that convalescent plasma is associated with reduced in-hospital mortality in COVID-19 patients.
• Early administration of CP (within 3 days) is crucial for achieving significant mortality benefits.
• Further evaluation of CP as a viable COVID-19 therapy is warranted, challenging premature abandonment.