Efficacy of early transfusion of convalescent plasma with high-titer SARS-CoV-2 neutralizing antibodies in hospitalized patients with COVID-19
Por:
Sanz, C, Nomdedeu, M, Pereira, A, Sauleda, S, Alonso, R, Bes, M, Brillembourg, H, Garcia-Vidal, C, Millan, A, Martinez-Llonch, N, Piron, M, Puerta-Alcalde, P, Puig, L, Rico, V, Soriano, A
Publicada:
1 may 2022
Ahead of Print:
1 mar 2022
Resumen:
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.
Filiaciones:
Sanz, C:
Hosp Clin Barcelona, Blood Bank & Transfus Serv, Barcelona, Spain
Nomdedeu, M:
Hosp Clin Barcelona, Hemathol & Hemotherapy Serv, Barcelona, Spain
Pereira, A:
Hosp Clin Barcelona, Blood Bank & Transfus Serv, Barcelona, Spain
Sauleda, S:
Banc Sang & Teixits, Barcelona, Spain
Alonso, R:
Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Dept, Barcelona, Spain
Bes, M:
Banc Sang & Teixits, Barcelona, Spain
Brillembourg, H:
Hosp Clin Barcelona, Blood Bank & Transfus Serv, Barcelona, Spain
Garcia-Vidal, C:
Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Dept, Barcelona, Spain
Millan, A:
Banc Sang & Teixits, Barcelona, Spain
Martinez-Llonch, N:
Banc Sang & Teixits, Barcelona, Spain
Piron, M:
Banc Sang & Teixits, Barcelona, Spain
Puerta-Alcalde, P:
Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Dept, Barcelona, Spain
Puig, L:
Banc Sang & Teixits, Barcelona, Spain
Rico, V:
Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Dept, Barcelona, Spain
Soriano, A:
Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Dept, Barcelona, Spain
Bronze
|