Treatment of Coronavirus Disease 2019 Patients with Convalescent Plasma Reveals a Signal of Significantly Decreased Mortality

Eric Salazar, Paul A. Christensen, Edward A. Graviss, Duc T. Nguyen, Brian Castillo, Jian Chen, Bevin V. Lopez, Todd N. Eagar, Xin Yi, Picheng Zhao, John Rogers, Ahmed Shehabeldin, David Joseph, Christopher Leveque, Randall J. Olsen, David W. Bernard, Jimmy Gollihar, James M. Musser

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has spread globally, and proven treatments are limited. Transfusion of convalescent plasma collected from donors who have recovered from COVID-19 is among many approaches being studied as potentially efficacious therapy. We are conducting a prospective, propensity score–matched study assessing the efficacy of COVID-19 convalescent plasma transfusion versus standard of care as treatment for severe and/or critical COVID-19. We present herein the results of an interim analysis of 316 patients enrolled at Houston Methodist hospitals from March 28 to July 6, 2020. Of the 316 transfused patients, 136 met a 28-day outcome and were matched to 251 non-transfused control COVID-19 patients. Matching criteria included age, sex, body mass index, comorbidities, and baseline ventilation requirement 48 hours from admission, and in a second matching analysis, ventilation status at day 0. Variability in the timing of transfusion relative to admission and titer of antibodies of plasma transfused allowed for analysis in specific matched cohorts. The analysis showed a significant reduction (P = 0.047) in mortality within 28 days, specifically in patients transfused within 72 hours of admission with plasma with an anti-spike protein receptor binding domain titer of ≥1:1350. These data suggest that treatment of COVID-19 with high anti–receptor binding domain IgG titer convalescent plasma is efficacious in early-disease patients.

Original languageEnglish (US)
Pages (from-to)2290-2303
Number of pages14
JournalAmerican Journal of Pathology
Volume190
Issue number11
DOIs
StatePublished - Nov 2020

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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