High-Dose Convalescent Plasma for Treatment of Severe COVID-19
De Santis et al.,
High-Dose Convalescent Plasma for Treatment of Severe COVID-19,
Emerging Infectious Diseases, doi:10.3201/eid2803.212299
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.
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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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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De Santis et al., 31 Mar 2022, Randomized Controlled Trial, Brazil, peer-reviewed, 23 authors, average treatment delay 9.0 days.
Abstract: RESEARCH
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
To assess whether high-dose coronavirus disease
(COVID-19) convalescent plasma (CCP) transfusion
may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients
with severe COVID-19 who were within 10 days of initial
symptom onset were eligible. Patients in the CCP group
received 3 daily doses of CCP (600 mL/d) in addition to
standard treatment; control patients received standard
treatment only. Primary outcomes were death rates at
days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days.
We enrolled 107 patients: 36 CCP and 71 control. At
day 30, death rates were 22% for CCP and 25% for the
control group; at day 60, rates were 31% for CCP and
35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between
groups. We conclude that high-dose CCP transfused
within 10 days of symptom onset provided no benefit for
patients with severe COVID-19.
Author affiliations: University of São Paulo, São Paulo, Brazil
(G.C. De Santis, L.C. Oliveira, E.V. Santos, S.K. Haddad,
B.P.A. Prado Jr., D.T. Covas, R.T. Calado); Hospital Estadual
de Serrana, Serrana, Brazil (P.M.M. Garibaldi, C.E.L. Almado);
Hospital Regional do Mato Grosso do Sul, Campo Grande, Brazil
(J. Croda); Fundação Oswaldo Cruz, Campo Grande (J. Croda);
Universidade do Mato Grosso do Sul, Campo Grande (J. Croda,
G.G.A. Arcanjo); Hospital São Camilo, São Paulo (É.A.F. Oliveira,
A.C. Tonacio, D.M. Langhi Jr.); Universidade Federal de São
Paulo, São Paulo (D.M. Langhi Jr., J.O. Bordin); Hospital Estadual
de Américo Brasiliense, Américo Brasiliense, Brazil (R.N. Gilio);
Hospital das Clínicas da Faculdade de Medicina de Ribeirão
Preto, Ribeirão Preto, Brazil (L.C. Palma); Faculdade de Medicina
de Ribeirão Preto da Universidade de São Paulo, São Paulo
(M.C. Pontelli, R. Gomes, C.H. Miranda, M.A. Martins, E. Arruda,
B.A.L. Fonseca)
DOI: https://doi.org/10.3201/eid2803.212299
548
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 opacifications, mainly
in posterior and peripheral areas of the lungs (2). The
most common laboratory test alterations are lymphopenia and elevated serum concentrations of inflammatory 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 specific 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..
Late treatment
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
WCH
provide treatment protocols.
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