Convalescent plasma for the treatment of patients with severe coronavirus disease 2019: A preliminary report

J Med Virol. 2021 Mar;93(3):1678-1686. doi: 10.1002/jmv.26537. Epub 2020 Oct 5.


Background: The role of convalescent plasma therapy for patients with coronavirus disease 2019 (COVID-19) is unclear.

Methods: We retrospectively compared outcomes in a cohort of critical COVID-19 patients who received standard care (SC Group) and those who, in addition, received convalescent plasma (CP Group).

Results: In total, 40 patients were included in each group. The median patient age was 53.5 years (interquartile range [IQR] 42-60.5), and the majority of patients required invasive ventilation (69, 86.2%). Plasma was harvested from donors after a median of 37 days (IQR 31-46) from the first positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) result and 26 days (IQR 21-32) after documented viral clearance; it was administered after a median of 10 days (IQR 9-10) from the onset of symptoms and 2.5 days (IQR 2-4) from admission to intensive care unit. The primary endpoint of improvement in respiratory support status within 28 days was achieved in 26 patients (65%) in the SC Group and 31 patients (77.5%) in the CP Group (p = .32). The 28-day all-cause mortality (12.5% vs. 2.5%; p = .22) and viral clearance (65% vs. 55%; p = .49) were not significantly different between the two groups. Convalescent plasma was not significantly associated with the primary endpoint (adjusted hazard ratio 0.87; 95% confidence interval 0.51-1.49; p = .62). Adverse events were balanced between the two study groups.

Conclusion: In severe COVID-19, convalescent plasma therapy was not associated with clinical benefits. Randomized trials are required to confirm our findings.

Keywords: COVID-19; SARS-CoV-2; convalescent plasma; coronavirus; passive immunotherapy.

MeSH terms

  • Adult
  • COVID-19 / immunology
  • COVID-19 / therapy*
  • COVID-19 Serotherapy
  • Female
  • Humans
  • Immunization, Passive / methods
  • Male
  • Middle Aged
  • Plasma / immunology*
  • Retrospective Studies
  • SARS-CoV-2 / immunology
  • Severity of Illness Index
  • Treatment Outcome