Convalescent Plasma Therapy in the management of COVID-19 patients-The newer dimensions

Transfus Clin Biol. 2021 May 19;S1246-7820(21)00070-7. doi: 10.1016/j.tracli.2021.04.009. Online ahead of print.

Abstract

Background: COVID 19 infection caused by novel coronavirus with no specific established treatment. Convalescent Plasma Therapy has been authorized as an off-label therapeutic procedure. We assessed the outcome of convalescent plasma (CP) units versus standard treatment on the complete recovery, improvement and 28 days' mortality of COVID 19 patients.

Materials and methods: The present was multi-centric case controlled observational prospective study. The study was conducted for a period of four and half months from July 15 2020 to 30 November 2020 after taking approval from the Expert Committee, Health & Family Welfare Department, Government of Odisha. Plasma therapy was applied on two groups of 1189 serious COVID patients (959 number of pre- critical and 230 number of critical patients) not responding to oxygen therapy. It was compared with non- transfused control group of 1243 patients (996 number of pre-critical and 247 number of critical patients).

Results: Discharge was better in (55.5%) transfused than (43%)in non-transfused pre-critical patients and the mortality was lower (44.3%) in transfused, (48.9%) than non-transfused critical patients respectively. Complete recovery was highest in those who were transfused with CP with neutralizing titer more than 1:160 (52.5%), 18-30 years' age group (64%), females (53%), 'O' Rh D positive blood group (51.5%). There was no adverse reaction due to CP transfusion.

Conclusions: CP is effective in improving the recovery rate with earlier discharge and decrease in the 28 days' mortality than in the control non-transfused group. CP with neutralizing antibody titer more than 1:160 has the best outcome with complete recovery and decrease in the mortality. It is more effective in treating pre-critical patients when transfused early, in female patients, in younger age group and in blood group 'O' Rh D positive.

Keywords: COVID 19 infection; Convalescent plasma; Early transfusion; Mortality.