Clinical Effect of Continuous High-dose Convalescent Plasma Therapy for Rapidly Progressing COVID-19

doi:10.19803/j.1672-8629.2021.09.01

Abstract

Abstract: Objective To investigate the therapeutic effect of convalescent plasma at different doses against cases of rapidly-progressing COVID-19. Methods Twenty-eight cases of COVID-19 who were hospitalized in Beijing Ditan Hospital between January 20, 2020 and January 31, 2021 and treated with convalescent plasma were retrospectively investigated. By means of propensity score matching, 28 patients in the convalescent plasma group and 53 patients in the non-convalescent plasma group were obtained. The treatment group was divided into the low-dose group (<1 200mL), medium-dose group (≥1 200mL,<2 000mL) and high-dose group (≥2 000mL) according to the doses of convalescent plasma. The difference in the recovery time, clinical improvement time, imaging inflammatory absorption time and nucleic acid negative conversion time was compared between these groups. Results Compared with the non-convalescent plasma group, the convalescent plasma group exhibited significantly reduced recovery time (P=0.004), clinical improvement time (P=0.006), and imaging inflammatory absorption time (P<0.001). Continuous high-dose of convalescent plasma contributed more to the recovery and clinical improvement of COVID-19 than the medium (P=0.002; P=0.044) and low dose (P<0.001; P=0.002). Conclusion For patients with rapidly-progressing COVID-19, continuous high-dose convalescent plasma therapy can promote recovery and clinical improvement.

Key words: COVID-2019, convalescent plasma, plasma therapy

CLC Number:

R973R974

ZHANG Tingyu, GE Ziruo, QIAN Fang, SONG Meihua, LI Xingang, TIAN Di, XU Yanli, CHEN Zhihai, ZHANG Wei. Clinical Effect of Continuous High-dose Convalescent Plasma Therapy for Rapidly Progressing COVID-19[J]. Chinese Journal of Pharmacovigilance, 2021, 18(9): 801-805.

References

[1] World Health Organization. Rolling updates on coronavirus disease (COVID-19) [EB/OL]. (2021-03-01)[2021-05-01]. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-asthey-happen.
[2] Casadevall A, Pirofski LA.The convalescent sera option forcont-aining COVID-19[J]. J Clin Invest, 2020, 130(4): 1545-1548.
[3] Wang Y, Zhang D, Du G, et al.Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial[J]. Lancet, 2020, 395(10236): 1569-1578.
[4] Zhou B, Zhong N, Guan Y.Treatment with convalescent plasma for influenza A (H5N1) infection[J]. N Engl J Med, 2007, 357(14): 1450-1451.
[5] Wu XX, Gao HN, Wu HB, et al.Successful treatment of avian-origin influenza A (H7N9) infection using convalescent plasma[J]. Int J Infect Dis, 2015, 41: 3-5.
[6] Hung IF, To KK, Lee CK, et al.Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection[J]. Clin Infect Dis, 2011, 52(4): 447-456.
[7] Kraft CS, Hewlett AL, Koepsell S, et al.The use of TKM-100802 and convalescent plasma in 2 patients with ebola virus disease in the United States[J]. Clin Infect Dis, 2015, 61(4): 496-502.
[8] Yeh KM, Chiueh TS, Siu LK, et al.Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital[J]. J Antimicrob Chemother, 2005, 56(5): 919-922.
[9] Cheng Y, Wong R, Soo YO, et al.Use of convalescent plasma therapy in SARS patients in Hong Kong[J]. Eur J Clin Microbiol Infect Dis, 2005, 24(1): 44-46.
[10] Ko JH, Seok H, Cho SY, et al.Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: a single centre experience[J]. Antivir Ther, 2018, 23(7): 617-622.
[11] Graham BS, Ambrosino DM.History of passive antibody administration for prevention and treatment of infectious diseases[J]. Curr Opin Hiv Aids, 2015, 10(3): 129-134.
[12] Gowen BB, Bray M.Progress in the experimental therapy of severe arenaviral infections[J]. Future Microbiol, 2011, 6(12): 1429-1441.
[13] WHO Mers-Cov Research Group. State of knowledge and data gaps of middle East respiratory syndrome coronavirus (MERS-CoV) in humans[J]. PLoS Curr, 2013, 12: 5.
[14] Cheng Y, Wong R, Soo YOY, et al.Use of convalescent plasma therapy in SARS patients in Hong Kong[J]. Eur J Clin Microbiol Infect Dis, 2005, 24(1): 44-46.
[15] Wong VWS, Dai D, Wu AKL, et al.Treatment of severe acute respiratory syndrome with convalescent plasma[J]. Hong Kong Med J, 2003, 9(3): 199-201.
[16] General Office of the National Health Commission. COVID-19 Prevention and Control Scheme (Trial 4th Edition)[EB/OL].(2020-01-27) [2021-02-01]. http://www.nhc.gov.cn/xcs/zhengcwj/202001/4294563ed35b43209b31739 bd0785e67.shtml.
[17] Food and Drug Administration. Recommendations for Investi-gational COVID-19 Convalescent Plasma[EB/OL].(2020-08-24)[2021-03-01]. www.fda.gov/vaccines-blood-biologics/investiga-tional-new-drug-ind-or-device-exemption-ide-process-cber/recommendations-investigational-covid-19-convalescent-plasma.
[18] Van Griensven J, Edwards T, de Lamballerie X, et al. Evaluation of convalescent plasma for Ebola virus disease in Guinea[J]. N Engl J Med, 2016, 374(1): 33-42.
[19] Researchgate, Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications[EB/OL].(2020-04-06)[2021-03-01].https://www.researchgate.net/publication/340471619_Neutralizing_antibody_responses_to_SARS-CoV-2_in_a_COVID-19_recovered_patient_cohort_and_their_implications.
[20] Garraud O, Heshmati F, Pozzetto B, et al.Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow[J]. Transfus Clin Biol, 2016, 23(1): 39-44.
[21] Koutsakos M, Rowntree LC, Hensen L, et al.Integrated immune dynamics define correlates of COVID-19 severity and antibody responses[J]. Cell Rep Med, 2021, 2(3): 100208.
[22] Li L, Zhang W, Hu Y, et al.Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial[J]. JAMA, 2020, 324(5): 460-470.
[23] Liu STH, Lin HM, Baine I, et al.Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study[J]. Nat Med, 2020, 26(11): 1708-1713.