Convalescent plasma treatment of severe COVID-19: a propensity score–matched control study
Sean T. H. Liu, Hung-Mo Lin, Ian Baine, Ania Wajnberg, Jeffrey P. Gumprecht, Farah Rahman, Denise Rodriguez, Pranai Tandon, Adel Bassily-Marcus, Jeffrey Bander, Charles Sanky, Amy Dupper, Allen Zheng, Freddy T. Nguyen, Fatima Amanat, Daniel Stadlbauer, Deena R. Altman, Benjamin K. Chen, Florian Krammer, Damodara Rao Mendu, Adolfo Firpo-Betancourt, Matthew A. Levin, Emilia Bagiella, Arturo Casadevall, Carlos Cordon-Cardo, Jeffrey S. Jhang, Suzanne A. Arinsburg, David L. Reich, Judith A. Aberg, Nicole M. Bouvier. Nature Medicine 2020-09-15
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments. Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. These antibodies, when transfused into patients infected with SARS-CoV-2, are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses. Virus-specific antibodies from recovered persons are often the first available therapy for an emerging infectious disease, a stopgap treatment while new antivirals and vaccines are being developed. This retrospective, propensity score–matched case–control study assessed the effectiveness of convalescent plasma therapy in 39 patients with severe or life-threatening COVID-19 at The Mount Sinai Hospital in New York City. Oxygen requirements on day 14 after transfusion worsened in 17.9% of plasma recipients versus 28.2% of propensity score–matched controls who were hospitalized with COVID-19 (adjusted odds ratio (OR), 0.86; 95% confidence interval (CI), 0.75–0.98; chi-square test P value = 0.025). Survival also improved in plasma recipients (adjusted hazard ratio (HR), 0.34; 95% CI, 0.13–0.89; chi-square test P = 0.027). Convalescent plasma is potentially effective against COVID-19, but adequately powered, randomized controlled trials are needed.