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

Marjolaine Destremau1, Hélène Chaussade1, Victor Hemar1

  • 1CHU Bordeaux, Service de médecine interne et maladies infectieuses, Bordeaux, France.

Journal of Medical Virology
|April 15, 2024
PubMed

Insights

Convalescent plasma transfusion (CPT) can clear the virus and improve outcomes for immunocompromised COVID-19 patients. This treatment showed reduced viral RNA and improved clinical status in a study of 81 patients.

Area of Science:

  • Immunology
  • Virology
  • Hematology

Background:

  • Immunocompromised patients face severe outcomes from COVID-19.
  • Convalescent plasma transfusion (CPT) is explored as a treatment option for these high-risk individuals.
  • Assessing CPT's efficacy and safety in this population is crucial.

Purpose of the Study:

  • To evaluate the safety, virological, and clinical outcomes of CPT in hospitalized immunocompromised patients with COVID-19.
  • To determine the impact of CPT on viral RNA levels and patient recovery.
  • To identify factors associated with mortality and adverse events post-CPT.

Main Methods:

  • Retrospective multicenter cohort study of 81 immunocompromised COVID-19 patients treated with CPT.
  • Inclusion criteria: immunosuppression, COVID-19, RNAemia.
  • Data collected on patient characteristics, treatment details, viral load (RNAemia), serology, and clinical outcomes including mortality.

Main Results:

  • CPT led to RNAemia negativity in 67.2% of patients by Day 7.
  • Post-CPT positive serology was linked to viral RNA negativity (p < 0.001).
  • Overall 28-day mortality was 26%, significantly higher in non-B-cell hematological malignancies (62%) versus others. Patients on anti-CD20 without chemotherapy had 8% mortality.

Conclusions:

  • CPT appears effective in eliminating viral RNA and improving the clinical course of COVID-19 in immunocompromised patients.
  • Early viral clearance (RNAemia negativity at D7) is associated with reduced mortality.
  • Further research into optimizing CPT for specific immunocompromised subgroups is warranted.

Keywords:
SARS coronaviruscombination therapydisease controlinfectionvirus classification

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