Convalescent plasma therapy improves outcomes for majority of COVID-19 patients in study

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The first US convalescent plasma trial, conducted at Houston Methodist (TX, USA), has revealed promising results, with the majority of patients improving as a result of the treatment, and with no adverse side effects. The study, published in the American Journal of Pathology, concluded that convalescent plasma therapy is a safe treatment option for patients with severe COVID-19.

This therapeutic approach dates back to at least as early as 1918 during the Spanish Flu pandemic, and was more recently applied during the 2003 SARS and 2009 influenza H1N1 pandemics and the 2015 Ebola outbreak.

Following a study in China at the beginning of the COVID-19 outbreak, in which a small number of patients showed improvement, a team at Houston Methodist began trialing convalescent plasma as a treatment for the disease.

“While physician scientists around the world scrambled to test new drugs and treatments against the COVID-19 virus, convalescent serum therapy emerged as potentially one of the most promising strategies,” commented James Musser (Houston Methodist), corresponding author of the study. “With no proven treatments or cures for COVID-19 patients, now was the time in our history to move ahead rapidly.”

Patients were initially treated under emergency use guidelines, but rapid FDA approval allowed the researchers to open up the trial to more patients as an investigational new drug.

The team observed clinical improvement in 19 out of 25 (76%) patients as a result of the treatment. They also concluded that any observed complications were consistent with previous reports of COVID-19 progression and did not result from the plasma transfusions.

They noted that these results were consistent with several other small case studies assessing convalescent plasma therapy for severe COVID-19.

Since the trial began, Houston Methodist has treated 74 critically ill COVID-19 patients, 50 of whom have been discharged from the hospital.

Moving forward, the team hope to determine the therapeutic efficacy of the treatment. They are now considering a randomized controlled trial in which they would also assess variables including timing of the transfusion after onset of symptoms, adjusting the number and volume of transfusions according to patient biometrics, and antibody levels in donor plasma, to evaluate how to optimize this therapy.

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Sources: Salazar E, Perez KK, Ashraf M et al., Treatment of COVID-19 Patients with Convalescent Plasma. Am J. Pathol. doi:10.1016/j.ajpath.2020.05.014 (2020); https://news.utexas.edu/2020/06/02/covid-19-convalescent-plasma-therapy-is-safe-with-76-of-patients-improving/

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