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Plasma Reduces Severe COVID-19

Early Plasma Treatment Reduces Severe COVID-19 in Older Adults

    Multiple drugs and therapies have been developed since the outbreak of the coronavirus to help patients recover from COVID-19. Among these treatments include convalescent plasma, a liquid part of the blood that contains antibodies against the coronavirus, donated by people who have recovered from COVID-19. However, there have been mixed results regarding treatment with convalescent plasma. A group of scientists from the Fundación INFANT in Buenos Aires, Argentina speculated a reason for the mixed results is that the plasma should be administered earlier in the course of illness for higher efficacy. These researchers conducted a clinical trial to test the effects of plasma treatment given early in the COVID-19 disease course. Their study results, which were published in the New England Journal of Medicine (NEJM) on January 6, 2021, suggest that an early plasma treatment reduces severe COVID-19 symptoms in older patients.

Background Info: Convalescent Plasma

    Convalescent plasma is a part of the blood taken from patients who have recovered from COVID-19. After exposure to the coronavirus, recovered patients develop antibodies specifically against the coronavirus which can be found in the blood. Antibodies are proteins produced by the immune system to target a specific virus (which in this case is COVID-19) and fight off infection. By injecting the antibody-containing convalescent plasma in COVID-19 patients, scientists hope that these antibodies can help the immune system in the fight against the virus and speed up recovery. (See Plasma for COVID-19 treatment for more)

About the Trial

    Researchers hypothesized that administering plasma treatment earlier in the course of illness may produce successful results. A clinical trial was conducted to test this theory which, according to the study results published in the NEJM, was a "randomized, double blind, placebo-controlled trial of convalescent plasma." The trial was conducted between June 4, 2020 and October 25, 2020 and consisted of 160 COVID-19 patients around Argentina. Trial participants were either 75 years or older or between 65 and 74 years with at least one pre-existing condition. After randomization, 80 patients received convalescent plasma within 72 hours after symptom offset while the other 80 patients received placebo (no treatment). The convalescent plasma was taken from donors who were infected with SARS-CoV-2 for a minimum of 10 days and had tested negative or been asymptomatic for at least 3 days.

Results

    Out of the 80 patients who received convalescent plasma, 16% developed severe respiratory disease and 2% died from COVID. In the placebo group, 31% of patients developed severe respiratory disease and 5% of patients died from COVID-19. The median time to develop severe respiratory disease was longer in the convalescent group than the placebo group. Overall, the relative risk for severe respiratory disease during COVID-19 infection was reduced by 48% for patients receiving convalescent plasma.

    Additionally, researchers found that convalescent plasma with high antibody levels was associated with a reduced risk of severe respiratory disease. Plasma with an antibody titer of 1:3200 or higher reduced risk of severe respiratory disease by 73%. This data confirms the theory that antibodies themselves are responsible for lessening the effects of the virus. 

   

Conclusion

   Previously, clinical trials with convalescent plasma have not always yielded successful results. However, this study finds that giving patients convalescent plasma within 3 days of COVID-19 diagnosis lowered risk for severe respiratory disease in older adults by 48%. The results suggest that convalescent plasma may be more effective in older adults if administered early in the disease course rather than later. This is a key finding as older adults are the most affected by the coronavirus and just simply administering plasma treatment early in the disease course could drastically "reduce demands on the healthcare system and may save lives." Furthermore, researchers discovered that convalescent plasma with high antibody levels were even more effective in reducing severe respiratory disease (73%), proving that antibodies are the element responsible for the beneficial effects of plasma.

Sources

1. Libster, Romina, et al. “Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults: NEJM.” New England Journal of Medicine, 31 Dec. 2020, www.nejm.org/doi/10.1056/NEJMoa2033700#figures_media. 

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