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Sekine L, Arns B, Fabro BR, Cipolatt MM, Machado RRG, Durigon EL, Parolo E, Pellegrini JAS, Viana MV, Schwarz P, Lisboa TC, Dora JMS, Portich JP, Paz AA, Silla L, Balsan AM, Schirmer FDS, Franz JPM, da-Silveira LM, Breunig RC, Petersen V, Sosnoski M, Mesquita NF, Volpato FCZ, Sganzerla D, Falavigna M, Rosa RG, Zavascki AP. Convalescent plasma for COVID-19 in hospitalised patients: an open-label, randomised clinical trial. Eur Respir J 2021; 59:13993003.01471-2021. [PMID: 34244316 PMCID: PMC8287736 DOI: 10.1183/13993003.01471-2021] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 01/05/2023]
Abstract
Background The effects of convalescent plasma (CP) therapy in hospitalised patients with coronavirus disease 2019 (COVID-19) remain uncertain. This study investigates the effect of CP on clinical improvement in these patients. Methods This is an investigator-initiated, randomised, parallel arm, open-label, superiority clinical trial. Patients were randomly (1:1) assigned to two infusions of CP plus standard of care (SOC) or SOC alone. The primary outcome was the proportion of patients with clinical improvement 28 days after enrolment. Results A total of 160 (80 in each arm) patients (66.3% critically ill, 33.7% severely ill) completed the trial. The median (interquartile range (IQR)) age was 60.5 (48–68) years; 58.1% were male and the median (IQR) time from symptom onset to randomisation was 10 (8–12) days. Neutralising antibody titres >1:80 were present in 133 (83.1%) patients at baseline. The proportion of patients with clinical improvement on day 28 was 61.3% in the CP+SOC group and 65.0% in the SOC group (difference −3.7%, 95% CI −18.8–11.3%). The results were similar in the severe and critically ill subgroups. There was no significant difference between CP+SOC and SOC groups in pre-specified secondary outcomes, including 28-day mortality, days alive and free of respiratory support and duration of invasive ventilatory support. Inflammatory and other laboratory marker values on days 3, 7 and 14 were similar between groups. Conclusions CP+SOC did not result in a higher proportion of clinical improvement on day 28 in hospitalised patients with COVID-19 compared to SOC alone. In this open-label, randomised clinical trial, two infusions of convalescent plasma therapy plus standard of care compared to standard of care did not result in higher proportion of clinical improvement on day 28 in patients with severe COVID-19https://bit.ly/2TXuB6S
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Affiliation(s)
- Leo Sekine
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Medical Sciences Post-Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz Arns
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bruna R Fabro
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Murillo M Cipolatt
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Rafael R G Machado
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison L Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, São Paulo, Brazil
| | - Edino Parolo
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Marina V Viana
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Patrícia Schwarz
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Thiago C Lisboa
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - José Miguel S Dora
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Internal Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Júlia P Portich
- Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Alessandra A Paz
- Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucia Silla
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Almeri M Balsan
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe da-Silva Schirmer
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Juliana P M Franz
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luciana M da-Silveira
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Raquel C Breunig
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Viviana Petersen
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Monalisa Sosnoski
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nanci F Mesquita
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Fabiana Caroline Z Volpato
- Laboratório de Diagnóstico de SARS-CoV-2, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Sganzerla
- Research Projects Office, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil
| | - Maicon Falavigna
- Research Projects Office, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil
| | - Regis G Rosa
- Intensive Care Service, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Alexandre P Zavascki
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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