Timing of convalescent plasma administration and 28-day mortality in COVID-19 pneumonia

• Main Authors: Carrera Ramos, P.M (Author), Estenssoro, E. (Author), Ferrando, N.S (Author), González Martínez, V.V (Author), González, S.E (Author), Kreplak, N. (Author), Pesci, S.A (Author), Regairaz, L. (Author), Salazar, M.R (Author), Vidal, J.M (Author)
• Format: Article
• Language: English
• Published: NLM (Medline) 2022
• Subjects: clinical trial; cohort analysis; Cohort Studies; COVID-19; human; Humans; Immunization, Passive; multicenter study; passive immunization; pneumonia; SARS-CoV-2; therapy
• Online Access: View Fulltext in Publisher

 This is a multicenter cohort study including consecutive, hospitalized patients ≥18 years, with moderate to severe COVID-19, carried out to evaluate the relationship between the timing of convalescent plasma administration and 28-day mortality. Data were prospectively collected between May 14, 2020 and October 31, 2020. Patients were grouped according to the timing of administration of convalescent plasma as <3 days, between 3 and 7 days, and >7 days. The main outcome variable was 28-day mortality. Independent predictors of mortality were identified by logistic regression. Of 4719 patients receiving convalescent plasma, 3036 (64.3%) were in the general ward, 1171 (24.8%) in the intensive care unit (ICU), and 512 (10.8%) in the ICU on mechanical ventilation. Convalescent plasma was administered to 3113 (66%) patients within the first 3 days of hospital admission, to 1380 (29.2%) between 3 and 7 days, and to 226 after 7 days; 28-day mortality was, respectively, 18.1%, 30.4% and 38.9% (p<0.001). In the regression model, convalescent plasma administration within the first 3 days of admission was associated with reduced 28-day mortality, compared with the administration after 7 days (OR 0.40, 95% CI 0.30 to 0.53). Early convalescent plasma administration was associated to a significant decreased mortality in patients in the general ward (OR 0.45, 95% CI 0.29 to 0.69) and in the ICU (OR 0.35, 95% CI 0.19 to 0.64), but not in those requiring mechanical ventilation (OR 0.52, 95% CI 0.27 to 1.01). In conclusion, this study suggests that early administration of convalescent plasma to patients with COVID-19 pneumonia is critical to obtain therapeutic benefit. © American Federation for Medical Research 2022. No commercial re-use. See rights and permissions. Published by BMJ.