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Convalescent plasma treatment of severe COVID-19: a propensity score–matched control study

2020; Nature Portfolio; Volume: 26; Issue: 11 Linguagem: Inglês

10.1038/s41591-020-1088-9

1546-170X

Sean Liu, Hung-Mo Lin, Ian Baine, Ania Wajnberg, Jeffrey P. Gumprecht, Farah Rahman, Denise Rodriguez, Pranai Tandon, Adel Bassily‐Marcus, Jeffrey Bander, Charles Sanky, Amy C. Dupper, Allen Zheng, Freddy T. Nguyen, Fatima Amanat, Daniel Stadlbauer, Deena R. Altman, Benjamin Chen, Florian Krammer, Damodara Rao Mendu, Adolfo Firpo‐Betancourt, Matthew A. Levin, Emilia Bagiella, Arturo Casadevall, Carlos Cordon‐Cardo, Jeffrey S. Jhang, Suzanne Arinsburg, David L. Reich, Judith A. Aberg, Nicole M. Bouvier,

COVID-19 Impact on Reproduction

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. Convalescent plasma for treatment of hospitalized patients with COVID-19 is associated with improved survival in a retrospective comparison with matched controls, supporting further study in randomized controlled trials.