Abstract
Background: Despite most controlled trials have shown no measurable benefit of COVID-19 convalescent plasma (CCP) in patients with COVID-19, some studies suggest that early administration of CCP with high-titer anti-SARS-CoV-2 can be beneficial in selected patients. We investigated the efficacy of early administration of high-titer CCP to patients with COVID-19 who required hospitalization, STUDY DESIGN AND METHODS: Observational, propensity score (PS) matched case-control study of COVID-19 patients treated with CCP within 72 h of hospital admission and untreated controls from August 2020 to February 2021. All CCP donations had a Euroimmun anti-SARS-CoV-2 sample-to-cutoff ratio ≥3. PS matching was based on prognostic factors and presented features with high-standardized differences between the treated and control groups. The primary endpoint was mortality within 30 days of diagnosis.
Results: A total of 1604 patients were analyzed, 261 of whom received CCP, most (82%) within 24 h after admission. Median age was 67 years (interquartile range: 56-79), and 953 (60%) were men. Presenting factors independently associated with higher 30-day mortality were increased age, cardiac disease, hypoxemic respiratory failure, renal failure, and plasma d-dimer >700 ng/ml. After PS matching, transfusion of CCP was associated with a significant reduction in the 30-day mortality rate (odds ratio [OR]; 0.94, 95% confidence interval [CI]: 0.91-0.98; p = .001) that extended to the 60th day after COVID-19 diagnosis (OR: 0.95; 95% CI: 0.92-0.99; p = .01).
Conclusion: Our results suggest that CCP can still be helpful in selected patients with COVID-19 and call for further studies before withdrawing CCP from the COVID-19 therapeutic armamentarium.
Keywords: FFP transfusion; blood center operations; transfusion practices (adult).
【저자키워드】 FFP transfusion, blood center operations, transfusion practices (adult)., 【초록키워드】 COVID-19, convalescent plasma, Efficacy, Respiratory failure, Mortality, Hospitalization, Diagnosis, anti-SARS-CoV-2, therapeutic, Patient, COVID-19 diagnosis, Controlled trial, Control, plasma, age, Hospital admission, cardiac disease, Admission, patients, Blood, case-control study, 30-Day mortality, primary endpoint, Odds ratio, COVID-19 patient, Prognostic factor, CCP, Factor, 95% confidence interval, control groups, early administration, renal, hypoxemic, high-titer CCP, men, feature, benefit, 30-day mortality rate, selected, shown, analyzed, investigated, required, treated, reduction in, interquartile, patients with COVID-19, 【제목키워드】 convalescent plasma, SARS-CoV-2 neutralizing antibody, hospitalized patient, with COVID-19,