Risk factors for COVID-19 mortality: The effect of convalescent plasma administration

PLoS One. 2021 Apr 29;16(4):e0250386. doi: 10.1371/journal.pone.0250386. eCollection 2021.

Abstract

Background: Convalescent plasma, widely utilized in viral infections that induce neutralizing antibodies, has been proposed for COVID-19, and preliminary evidence shows that it might have beneficial effect. Our objective was to determine the risk factors for 28-days mortality in patients who received convalescent plasma for COVID-19 compared to those who did not, who were admitted to hospitals in Buenos Aires Province, Argentina, throughout the pandemic.

Methods: This is a multicenter, retrospective cohort study of 2-month duration beginning on June 1, 2020, including unselected, consecutive adult patients with diagnosed COVID-19, admitted to 215 hospitals with pneumonia. Epidemiological and clinical variables were registered in the Provincial Hospital Bed Management System. Convalescent plasma was supplied as part of a centralized, expanded access program.

Results: We analyzed 3,529 patients with pneumonia, predominantly male, aged 62±17, with arterial hypertension and diabetes as main comorbidities; 51.4% were admitted to the ward, 27.1% to the Intensive Care Unit (ICU), and 21.7% to the ICU with mechanical ventilation requirement (ICU-MV). 28-day mortality was 34.9%; and was 26.3%, 30.1% and 61.4% for ward, ICU and ICU-MV patients. Convalescent plasma was administered to 868 patients (24.6%); their 28-day mortality was significantly lower (25.5% vs. 38.0%, p<0.001). No major adverse effects occurred. Logistic regression analysis identified age, ICU admission with and without MV requirement, diabetes, and preexistent cardiovascular disease as independent predictors of 28-day mortality, whereas convalescent plasma administration acted as a protective factor.

Conclusions: Our study suggests that the administration of convalescent plasma in COVID-19 pneumonia admitted to the hospital might be associated with improved outcomes.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality
  • COVID-19 / therapy*
  • COVID-19 Serotherapy
  • Female
  • Humans
  • Immunization, Passive / methods
  • Intensive Care Units
  • Male
  • Middle Aged
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification
  • Treatment Outcome

Grant support

The author(s) received no specific funding for this work.