Plasma could reduce the mortality of COVID-19
Treatment used in past for polio, measles, flu
Although preliminary and drawn from a very small sample size, results from the first U.S. study evaluating the use of survivor plasma to treat COVID-19 patients showed a 50% reduction in mortality when used early.
The study, which has yet to be peer-reviewed, evaluated plasma’s effects on 39 patients with severe to life-threatening COVID-19 at The Mount Sinai Hospital in New York.
The study, which was conducted by researchers at Mount Sinai’s Icahn School of Medicine, also showed the treatment was more effective on patients who had not been intubated.
It was posted online Friday.
“This initial assessment offers evidence in support of convalescent plasma transfusion as an effective intervention in COVID-19,” the paper says. “Preliminary data suggest a potential mortality benefit, but greater numbers are needed to draw definitive conclusions.”
The paper comes a week after a larger study on the safety of survivor plasma also showed promising results.
The safety study, which reported on 5,000 patients, said the number of severe adverse events within four hours of receiving plasma was less than 1%.
That study, which also has not yet been peer-reviewed, found “no signal of toxicity” and concluded “the mortality rate does not appear excessive.”
Survivor plasma carries antibodies
Using plasma from those who have recovered from a disease to treat those still sick with it is a technique that dates back more than a century to the treatment of a German child suffering from diphtheria.
Since then, the method has been used “to stem outbreaks of viral diseases such as poliomyelitis, measles, mumps and influenza,” according to a recent paper in The Journal of Clinical Investigation.
The treatment is premised on the idea that plasma from survivors should be rich in the antibodies that have helped them to defeat the virus. The plasma provides the recipient with an immediate immune response, rather than requiring them to wait for their own immune system to kick in.
Plasma does carry potential side effects, including fever, allergic reaction and a very small risk of infectious disease transmission.
Survivor plasma has previously shown success against a different coronavirus, Severe Acute Respiratory Syndrome, or SARS.
The researchers from the Ichan School of Medicine are hopeful survival plasma will show similar benefits in treating COVID-19.
“We are encouraged that our initial assessment offers evidence in support of convalescent plasma as an effective intervention, while remaining mindful that additional studies are needed to confirm these findings and draw more definitive conclusions in different populations,” Nicole Bouvier, associate professor of medicine at the Icahn School and co-senior author of the paper, said in a news release.
Details of the study
The study, which has yet to be peer-reviewed, evaluated plasma’s effects on 39 patients with severe to lifethreatening COVID-19 at The Mount Sinai Hospital in New York.
Patients involved in the study were hospitalized at Mount Sinai Hospital in New York between March 24 and April 8. It was not a randomized clinical trial, in which patients are randomly placed into a treatment group or a control group. A random trial is considered the most rigorous type of evaluation.
Rather, this trial used matched control data, comparing patients treated with plasma to patients with similar characteristics found in the hospital’s electronic health record database.
The average age of patients who received the survivor plasma was 55, and two-thirds of them were male, the paper says.
Fifty-four percent of them were obese. People who received the plasma were more likely than controls to remain the same or need less supplemental oxygen after 14 days, the study says.
As of May 1, 12.8% of the people who received plasma had died compared to 24.4% of matched control patients.
The treatment was more effective for people who had not been placed on ventilators.
The data suggests it took more than a week for the transfusions to show “survival effects,” the paper says.
“If this observation is borne out in subsequent studies, it could indicate that convalescent plasma prevents longer-term complications, such as acute lung injury or multi-organ dysfunction syndrome,” the paper says.
“However, this speculation awaits confirmation in a larger patient cohort.”