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Published on: January 31, 2025
Convalescent Plasma for Hospitalized COVID-19 Patients: A Single-Center Experience
Massimo Franchini1, Claudia Glingani1, Giuseppe De Donno2
1Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy.
Insights
COVID-19 convalescent plasma (CCP) was an early treatment for severe COVID-19 in Italy. Early CCP administration with high antibody titers showed a safe and effective response in hospitalized patients.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- The COVID-19 pandemic severely impacted Italy, with the Lombardy region being an early epicenter.
- COVID-19 convalescent plasma (CCP) emerged as a primary therapeutic intervention against SARS-CoV-2.
- Understanding the real-world effectiveness of CCP is crucial for managing severe cases.
Purpose of the Study:
- To evaluate the safety and efficacy of compassionate use of CCP in hospitalized COVID-19 patients.
- To identify factors associated with a favorable response to CCP treatment.
- To report the initial experience with CCP therapy in the Western hemisphere.
Main Methods:
- Retrospective cohort study involving 405 hospitalized COVID-19 patients treated with CCP between April 2020 and April 2021.
- Analysis of patient demographics, comorbidities, disease severity, and CCP characteristics, including neutralizing antibody (nAb) titers.
- Assessment of 28-day mortality rates and adverse reactions associated with CCP administration.
Main Results:
- The median age of patients was 68 years, with 62% males and significant prevalence of increased BMI and comorbidities.
- The 28-day crude mortality rate was 12.6%.
- Favorable outcomes were associated with younger age, milder disease, early treatment initiation (<7 days), and high nAb titer CCP (≥320).
- CCP treatment demonstrated a favorable safety profile, with only 1.3% mild adverse reactions.
Conclusions:
- Early administration of high-titer CCP is a safe and effective therapeutic strategy for hospitalized COVID-19 patients.
- Factors such as early intervention and high neutralizing antibody levels significantly improve treatment outcomes.
- This study provides valuable insights into the real-world application of CCP in the early stages of the pandemic.
Abstract:
In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80−320). Their median age was 68 years (IQR, 56−78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (<68 years), mild disease (admission to low-intensity departments) and early treatment (<7 days from symptoms onset) with high nAb titer (≥320) CCP were found as independently associated with a favorable response to CCP treatment. No safety concerns were recorded, with a rate of CCP-related adverse reactions (all of mild intensity) of 1.3%. In our real-life experience, the first in the western world, early administration of high-titer CCP was a safe and effective treatment for hospitalized COVID-19 patients.
