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Effect of convalescent plasma as complementary treatment in patients with moderate COVID-19 infection

Baldeón et al., Transfusion Medicine, doi:10.1111/tme.12851
Jan 2022  
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Mortality 12% Improvement Relative Risk Conv. Plasma  Baldeón et al.  LATE TREATMENT  DB RCT Is late treatment with convalescent plasma beneficial for COVID-19? Double-blind RCT 158 patients in Ecuador (May 2020 - January 2021) Trial underpowered to detect differences c19early.org Baldeón et al., Transfusion Medicine, Jan 2022 Favorsconv. plasma Favorscontrol 0 0.5 1 1.5 2+
RCT 158 patients in Ecuador, showing no significant difference in mortality with convalescent plasma. Authors note indications of improved results for earlier treatment.
risk of death, 12.0% lower, RR 0.88, p = 1.00, treatment 7 of 63 (11.1%), control 12 of 95 (12.6%), NNT 66.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Baldeón et al., 9 Jan 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Ecuador, peer-reviewed, 17 authors, study period May 2020 - January 2021, average treatment delay 10.6 days. Contact: mabaldeonti@uide.edu.ec.
This PaperConv. PlasmaAll
Effect of convalescent plasma as complementary treatment in patients with moderate COVID ‐19 infection
Manuel E Baldeón, Augusto Maldonado, Miguel Ochoa‐andrade, Carolina Largo, Mónica Pesantez, Marco Herdoiza, Gerardo Granja, Marco Bonifaz, Hugo Espejo, Francisco Mora, Patricio Abril‐lópez, Lady Karen Robles Armijo, Verónica Pacheco, Rafael Salazar, Steffy Reinthaller, Federico Zertuche, Marco Fornasini
Transfusion Medicine, doi:10.1111/tme.12851
Introduction: South America is one of the regions most affected by the COVID-19 pandemic. Specific and affordable treatments are needed to treat SARS-CoV-2 infection. Evidence regarding the use of convalescent plasma in COVID-19 patients is still limited. We compared the safety and efficacy of COVID-19-convalescent plasma administration as a complement to standard treatment in the early management of patients with moderate SARS-CoV-2 infection. Methods: We carried out a random double blinded, placebo-controlled trial that compared standard treatment plus convalescent plasma (CP) or plus non-convalescent plasma in the management of COVID-19 patients. The main outcome was survival and secondary endpoints included: length of hospitalisation (LOH), days from treatment to discharge, time to clinical improvement or death within a 28-day period, and adverse reactions to treatment. Results: Administration of CP with antibodies against SARS-CoV-2 did not affect patient survival, RR = 1.003, 95% CI (0.3938, 2.555). These results led to terminate the RCT prematurely. However, early treatment of COVID-19 patients with CP tended to decrease the LOH while the delay in CP treatment was associated with longer hospitalisation. In addition, delay in CP treatment negatively affected the recovery of the respiratory rate. Conclusion: Use of CP for the treatment of COVID-19 patients is safe and its early use can decrease the LOH and improve respiratory function. Early administration of antibody-rich CP could contribute to decrease the negative impact of COVID-19 pandemic in patients with impaired immune response.
CONFLICT OF INTEREST The authors declare no conflict of interest.
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Late treatment
is less effective
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