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0 0.5 1 1.5 2+ Mortality, day 60 13% Improvement Relative Risk Mortality, day 30 12% Conv. Plasma  De Santis et al.  LATE TREATMENT  RCT Is late treatment with convalescent plasma beneficial for COVID-19? RCT 107 patients in Brazil No significant difference in mortality De Santis et al., Emerging Infectious .., Mar 2022 Favors conv. plasma Favors control

High-Dose Convalescent Plasma for Treatment of Severe COVID-19

De Santis et al., Emerging Infectious Diseases, doi:10.3201/eid2803.212299
Mar 2022  
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RCT 110 hospitalized patients in Brazil, showing no significant difference in outcomes with high-dose convalescent plasma.
risk of death, 13.2% lower, RR 0.87, p = 0.67, treatment 11 of 36 (30.6%), control 25 of 71 (35.2%), NNT 21, day 60.
risk of death, 12.3% lower, RR 0.88, p = 0.81, treatment 8 of 36 (22.2%), control 18 of 71 (25.4%), NNT 32, day 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
De Santis et al., 31 Mar 2022, Randomized Controlled Trial, Brazil, peer-reviewed, 23 authors, average treatment delay 9.0 days.
This PaperConv. PlasmaAll
High-Dose Convalescent Plasma for Treatment of Severe COVID-19
Gil C De Santis, Luciana Correa Oliveira, Pedro M M Garibaldi, Carlos E L Almado, Julio Croda, Ghislaine G A Arcanjo, Érika A F Oliveira, Adriana C Tonacio, Dante M Langhi Jr, José O Bordin, Renato N Gilio, Leonardo C Palma, Elaine V Santos, Simone K Haddad, Benedito P A Prado Jr, Marjorie Cornejo Pontelli, Rogério Gomes, Carlos H Miranda, Maria Auxiliadora Martins, Dimas T Covas, Eurico Arruda, Benedito A L Fonseca, Rodrigo T Calado
Emerging Infectious Diseases, doi:10.3201/eid2803.212299
C linical signs and symptoms of coronavirus disease (COVID-19) are pleomorphic, varying from none (asymptomatic) to life-threatening. Typical signs/ symptoms are fever, dry cough, dyspnea, fatigue, myalgia, anosmia, and ageusia (1). Radiography or computed tomography of the chest usually reveals bilateral pulmonary ground-glass opacifi cations, mainly in posterior and peripheral areas of the lungs (2). The most common laboratory test alterations are lymphopenia and elevated serum concentrations of infl ammatory biomarkers and D-dimers (3). Risk factors for unfavorable outcomes are older age, concurrent conditions, and perhaps but of lesser importance, blood type A (4,5). Thus far, there is no consensual agreement about specifi c therapy for this disease, despite several attempts to develop one (3,6). More recently, antiviral agents such as MK-4482/EIDD-2801 and PF-07321332 seem to be promising (7,8). In the past, passive antibody transfer by plasma or serum transfusion has been used clinically to treat other infectious diseases, including Ebola, infl uenza A, severe acute respiratory syndrome, and Middle East respiratory syndrome, as well as . The presence of antiviral antibodies, in patient serum or in COVID-19 convalescent plasma (CCP), has been associated with more favorable clinical outcomes (14). Thus, CCP seems to be an attractive therapy because it is a potential source of neutralizing antibodies (15, 16) . The fi rst case series reported from China suggested favorable outcomes for 5 patients receiving undergoing mechanical ventilation who received CCP on days 10-22 after hospital admission (17). Also in China, 10 critically ill patients received 200 mL of CCP with a neutralizing antibody titer of >640, which resulted in undetectable viral load and clinical improvement for 7 of the 10 patients (18). In a nonrandomized
About the Author Dr. De Santis is a clinical hematologist at the University of São Paulo. His research interests include blood transfusion and cellular therapy, such as laboratory support for hematopoietic stem cell transplantation.
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Address For ; Gil, Santis, Rua Tenente Catão Roxo
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Late treatment
is less effective
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