Convalescent Plasma Treatment for Moderate to Critical Ill COVID-19 Patients – A Safe but Futile Treatment: A Non-Randomized Comparative Study
DOI:
https://doi.org/10.26911/theijmed.2023.08.04.08Abstract
Background: In a number of cases of viral infection, convalescent plasma therapy has been effective. Reportedly, the use of convalescent plasma as a therapy for COVID-19 patients with severe and life-threatening disorders is beneficial at this time. This study aims to assess the effectiveness and safety of convalescent plasma transfusions in hospitalized COVID-19 patients.
Subjects and Method: This was a clinical trial employing a non-randomized comparative study. A historical control group (21 samples) and convalescent plasma transfusions (21 samples) was selected consecutively from hospitalized COVID-19 patients between May 6th, 2020, and May 6th, 2021 at Dr. Moewardi General Hospital. We assessed and quantified viral clearance in the laboratory. Statistical analysis is performed in SPSS version 20.0.
Results: Plasma was taken from fifteen convalescent donors. In the plasma convalescent treatment group, there was a statistically significant difference between outcome and severity degree (p = 0.005). In addition, there was a substantial discrepancy between the result group and the control group (p 0.005). Significant differences in post-treatment NLR between the control and treatment groups (p 0.005). In addition, there were statistically significant differences between the control and treatment groups in post-treatment hsCRP levels (p 0.005). In addition, there were statistically significant differences (p 0.005) between all groups' inflammatory markers and outcomes.
Conclusion: Using convalescent plasma to treat patients with COVID-19 is a rather safe practice. Our analysis demonstrated that the administration of convalescent plasma did not enhance survival or clinical outcomes for COVID-19 patients with moderate to severe disease.
Keywords: COVID-19, convalescent therapy, critical ill
References
Berkhout SG, Abbey S, Sheehan KA (2023). Burnout and distress amongst healthcare workers during COVID-19: can we offer more than bandaid solutions?. Can J Cardiol. Doi: 10.1016/j.cjca.2023.01.027.
Casadevall A, Pirofski LA (2020). The convalescent sera option for containing COVID19. J. Clin. Investig. 130: 4. Doi: 10.1172/JCI138003.
Chavda VP, Bezbaruah R, Dolia S, Shah N, Verma S, Savale S, Ray S (2023). Convalescent plasma (hyperimmune immunoglobulin) for COVID19 management: An update. Process Biochemistry. 127: 66–81. Doi: 10.1016/j.procbio.2023.01.018.
Cho K, Keithly SC, Kurgansky KE, Madenci AL, Gerlovin H, MarucciWellman H, Doubleday A (2021). Early convalescent plasma therapy and mortality among us veterans hospitalized with nonsevere COVID-19: an observational analysis emulating a target trial. J. Infect. Dis. 224(6). Doi: 10.1093/infdis/jiab330.
Cho Y, Sohn Y, Hyun J, Baek Y, Kim M, Kim J, Ahn J (2021a). Effectiveness of convalescent plasma therapy in severe or critically ill COVID-19 patients: A retrospective cohort study. Yonsei Med J. 62(9): 799–805. Doi: 10.3349/ymj.2021.62.9.799.
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, Zhou M (2020a). Effectiveness of convalescent plasma therapy in severe COVID-19 patients. 117(17). Doi: 10.1073/pnas.2004168117.
Failure SO (2023b). Treatment of 5 Critically Ill Patients with COVID-19 with Convalescent Plasma. 323(16): 1582–1589. Doi: 10.1001/jama.2020.4783.
Florescu DF, Kalil AC, Hewlett AL, Schuh AJ, Stroher U, Uyek TM, Smith PW (2015). Administration of Brincidofovir and Convalescent Plasma in a Patient With Ebola Virus Disease. 61: 969–973. Doi: 10.1093/cid/civ395.
Hung IFN, To KKW, Lee C, Lee K, Chan K, Yan W, Liu R (2011a). Convalescent Plasma Treatment Reduced Mortality in Patients with Severe Pandemic Influenza A ( H1N1 ) 2009. Virus Infection. 52: 447–456. Doi: 10.1093/cid/ciq106.
Kementerian Kesehatan RI. (2020). Pedoman Pencegahan dan Pengendalian CORONA VIRUS DISEASE (COVID19) Revisi ke5 (2nd ed., Vol. 5). Kementerian Kesehatan RI.
Kraft CS, Hewlett AL, Koepsell S, Winkler AM, Kratochvil CJ, Larson L, Varkey JB (2015). The Use of TKM100802 and Convalescent Plasma in 2 Patients With Ebola Virus Disease in the United States. 61: 496–502. Doi: 10.1093/cid/civ334.
Mada UG, Setiawan SA (2020). Convalescent plasma for COVID-19 : a reasonable option for the pandemic based on both scientific and practical points of view Convalescent plasma for COVID-19 : a reasonable option for the pandemic based on a both scientific and practical points of view. Doi: 10.19106/JMedSciSI005203202011.
Martin B, DeWitt PE, Russell S, Anand A, Bradwell KR, Bremer C, Gabriel D (2022). Characteristics, Outcomes, and Severity Risk Factors Associated With SARSCoV2 Infection Among Children in the US National COVID Cohort Collaborative. JAMA Network Open. 5(2): e2143151. Doi: 10.1001/jamanetworkopen.2021.43151.
Maulana MS (2020). Efektivitas Efikasi Pemberian Terapi Konvalesen Plasma Pada Pasien Covid19: Evidence Based Case Report. Jurnal Kedokteran Dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya. 7(3): 7–14. Doi: 10.32539/jkk.v7i3.12297
Paul W, Weidner L, Theresia M, Neuhold S, Laurin E, Zoufaly A, Seitz T (2021). Adjunctive treatment with high titer convalescent plasma in severely and critically ill COVID-19 patients – a safe but futile intervention. A comparative cohort study. Infect Dis. 1–10. Doi 10.1080/23744235.2021.1940271.
Rejeki MS, Sarnadi N, Wihastuti R, Fazharyasti V, Samin WY, Yudhaputri FA, Johar E (2021). Convalescent plasma therapy in patients with moderate to severe COVID-19: A study from Indonesia for clinical research in low and middle-income countries. EclinicalMedicine. 36: 100931. Doi: 10.1016/j.eclinm.2021.100931.
Sall AA, Fransen K, Buyze J, Ravinetto R, Tiberghien P, Claeys Y, Crop M De (2020). Evaluation of Convalescent Plasma for Ebola Virus Disease in Guinea. 33–42. Doi: 10.1056/NEJMoa1511812.
Sharma J, Rajput R, Bhatia M, Arora P, Sood V, Smallwood HS (2021). Clinical Predictors of COVID-19 Severity and Mortality : A Perspective Clinical Predictors of COVID-19 Severity and Mortality : A Perspective. Doi: 10.3389/fcimb.2021.674277.
Shoaib N, Noureen N, Munir R, Ali F, Id S (2021). COVID-19 severity : Studying the clinical and demographic risk factors for adverse outcomes. 1–10. Doi: 10.1371/journal.pone.0255999.
Wooding DJ, Bach H (2020a). Treatment of COVID-19 with convalescent plasma : lessons from past coronavirus outbreaks. Clin. Microbiol. Infect. 26(10): 1436–1446. Doi: 10.1016/j.cmi.2020.08.005.
WHO (2022). WHO Therapeutics and COVID-19: Living Guideline. World Health Organisation, July.
WHO (2020). Novel Coronavirus (2019nCoV): situation report. 10. https://apps.who.int/iris/handle/10665/330775.
Zhou B, Zhong N, Guan Y (2007). Treatment with Convalescent Plasma for Influenza A (H5N1) Infection. N Eng J Med. 357(14): 1450–1451. Doi: 10.1056/NEJMc070359.
