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J Clin Med
. 2021 May 14;10(10):2113.
doi: 10.3390/jcm10102113.
Convalescent Plasma Efficacy in Life-Threatening COVID-19 Patients Admitted to the ICU: A Retrospective Cohort Study
Mohamed Abuzakouk 1 2 , Khaled Saleh 3 , Manuel Algora 2 4 , Ahmad Nusair 5 , Jawahir Alameri 6 , Fatema Alshehhi 6 , Sara Alkhaja 6 , Mohamed Badr 3 , Khaled Abdallah 3 , Bruno De Oliveira 3 , Ashraf Nadeem 3 , Yeldho Varghese 3 , Dnyaseshwar Munde 3 , Shameen Salam 3 , Baraa Abduljawad 3 , Hussam Elkambergy 3 , Ali Wahla 2 , Ahmed Taha 3 , Jamil Dibu 3 , Ahmed Bayrlee 3 , Fadi Hamed 3 , Laila AbdelWareth 4 , Nadeem Rahman 3 , Jorge Guzman 3 , Jihad Mallat 2 3 7
Affiliations
- PMID: 34068847
- DOI: 10.3390/jcm10102113
Abstract
(1) Background: There are limited data regarding the efficacy of convalescent plasma (CP) in critically ill patients admitted to the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). We aimed to determine whether CP is associated with better clinical outcome among these patients. (2) Methods: A retrospective single-center study including adult patients with laboratory-confirmed SARS-CoV-2 infection admitted to the ICU for acute respiratory failure. The primary outcome was time to clinical improvement, within 28 days, defined as patient discharged alive or reduction of 2 points on a 6-point disease severity scale. (3) Results: Overall, 110 COVID-19 patients were admitted. Thirty-two patients (29%) received CP; among them, 62.5% received at least one CP with high neutralizing antibody titers (≥1:160). Clinical improvement occurred within 28 days in 14 patients (43.7%) of the CP group vs. 48 patients (61.5%) in the non-CP group (hazard ratio (HR): 0.75 (95% CI: 0.41-1.37), p = 0.35). After adjusting for potential confounding factors, CP was not independently associated with time to clinical improvement (HR: 0.53 (95% CI: 0.23-1.22), p = 0.14). Additionally, the average treatment effects of CP, calculated using the inverse probability weights (IPW), was not associated with the primary outcome (-0.14 days (95% CI: -3.19-2.91 days), p = 0.93). Hospital mortality did not differ between CP and non-CP groups (31.2% vs. 19.2%, p = 0.17, respectively). Comparing CP with high neutralizing antibody titers to the other group yielded the same findings. (4) Conclusions: In this study of life-threatening COVID-19 patients, CP was not associated with time to clinical improvement within 28 days, or hospital mortality.
Keywords: SARS-CoV-2; convalescent plasma; critically ill; intensive care unit; life-threatening COVID-19; mechanical ventilation; neutralizing antibody.