Convalescent plasma treatment of severe COVID-19: a propensity score–matched control study

• Published in: Nature medicine Vol. 26; no. 11; pp. 1708 - 1713
• Main Authors: Liu, Sean T. H., Lin, Hung-Mo, Baine, Ian, Wajnberg, Ania, Gumprecht, Jeffrey P., Rahman, Farah, Rodriguez, Denise, Tandon, Pranai, Bassily-Marcus, Adel, Bander, Jeffrey, Sanky, Charles, Dupper, Amy, Zheng, Allen, Nguyen, Freddy T., Amanat, Fatima, Stadlbauer, Daniel, Altman, Deena R., Chen, Benjamin K., Krammer, Florian, Mendu, Damodara Rao, Firpo-Betancourt, Adolfo, Levin, Matthew A., Bagiella, Emilia, Casadevall, Arturo, Cordon-Cardo, Carlos, Jhang, Jeffrey S., Arinsburg, Suzanne A., Reich, David L., Aberg, Judith A., Bouvier, Nicole M.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.11.2020; Nature Publishing Group
• Subjects: 692/308/409; 692/699/255/2514; Adult; Aged; Antibodies; Antibodies, Viral - blood; Antiviral agents; Antiviral drugs; Biomedical and Life Sciences; Biomedicine; Cancer Research; Case-Control Studies; Chi-square test; Clinical trials; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - pathology; COVID-19 - therapy; Disease control; Female; Health services; Humans; Immunization, Passive; Infectious Diseases; Letter; Male; Metabolic Diseases; Middle Aged; Molecular Medicine; Neurosciences; Oxygen requirement; Pandemics; Patients; Plasma; Propensity Score; Public health; Respiratory diseases; Retrospective Studies; SARS-CoV-2 - immunology; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Statistical tests; Survival; Transfusion; Treatment Outcome; Viral diseases; Viruses; United States
• ISSN: 1078-8956; 1546-170X; 1546-170X
• DOI: 10.1038/s41591-020-1088-9

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments 1 . Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. These antibodies, when transfused into patients infected with SARS-CoV-2, are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses 2 , 3 . Virus-specific antibodies from recovered persons are often the first available therapy for an emerging infectious disease, a stopgap treatment while new antivirals and vaccines are being developed 1 , 2 . This retrospective, propensity score–matched case–control study assessed the effectiveness of convalescent plasma therapy in 39 patients with severe or life-threatening COVID-19 at The Mount Sinai Hospital in New York City. Oxygen requirements on day 14 after transfusion worsened in 17.9% of plasma recipients versus 28.2% of propensity score–matched controls who were hospitalized with COVID-19 (adjusted odds ratio (OR), 0.86; 95% confidence interval (CI), 0.75–0.98; chi-square test P value = 0.025). Survival also improved in plasma recipients (adjusted hazard ratio (HR), 0.34; 95% CI, 0.13–0.89; chi-square test P  = 0.027). Convalescent plasma is potentially effective against COVID-19, but adequately powered, randomized controlled trials are needed. Convalescent plasma for treatment of hospitalized patients with COVID-19 is associated with improved survival in a retrospective comparison with matched controls, supporting further study in randomized controlled trials.