Use of convalescent plasma in patients with COVID-19
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Abstract
Introducton: We wished to evaluate the clinical effectiveness of convalescent plasma (CP) in coronavirus disease 2019 (COVID-19) patients treated in hospitals in the Kuyavian-Pomeranian Voivodeship, including the impact of treatment duration and CP antibody titer on the course of hospitalization and patient survival in relation to other risk factors.
Material and methods: This was a retrospective analysis of clinical data of CP use in hospitals in the Kuyavian-Pomeranian Voivodeship.
Results: A total of 3,596 patients had available clinical data. In 59% of patients, CP was administered during the initial 24 hours of hospitalization (median: 1 day, range 1–49). In cured patients, hospital length of stay correlated with time of CP administration (p <0.001), i.e. the sooner the COVID-19 convalescent plasma (CCP) was administered, the shorter the hospitalization. Overall survival in analyzed COVID-19 patients was 78.3%, and it was better when CP was administered during the first day of hospitalization (79.9% vs. 86.8%, p = 0.057), in younger patients (91.0% vs. 76.2% for patients <50 years and older, respectively; p <0.001); in patients not requiring invasive ventilation (78.7% vs. 26.9%, p <0.001), in good performance status patients (92.5% vs. 81.0% and 68.6% in patients in moderate and poor performance status, respectively; p <0.001); and in patients without comorbidities (88.6% vs. 75.9%, p <0.001). In turn, blood group and titers of antibodies against severe acute respiratory syndrome coronavirus 2 in CP had no impact on survival. In multivariate analysis, the following factors increased the risk of death from COVID-19: general clinical status at admission (poor > moderate > good), comorbidities, mechanical ventilation required. Risk of death was decreased in younger patients (continuous variable), while administration of CP within the first day of hospitalization had borderline significance (p = 0.077). The use of CP was a safe therapeutic approach. Mild reactions were reported after just 5/9,356 (0.05%) transfusions.
Conclusions: The early administration of CP had a beneficial effect on the clinical course of treatment in COVID-19 patients.
Keywords: convalescent plasmaCOVID-19SARS-CoV-2
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