The pandemic of severe acute respiratory syndrome coronavirus (SARS-CoV-2) continue to infect thousands day by day. As of 29 march, 680,000 cases with 31,100 death have been reported worldwide. No vaccines or drugs are available specifically for covid19. Drugs like Remdesivir, Chloroquine, Lopinavir/Ritonavir are in clinical trials.
A study was conducted in China to check whether convalescent plasma transfusion containing neutralizing antibodies could be beneficial in treatment of critically ill patients with COVID19. In an uncontrolled study, 5 cases of critically ill patient with COVID19 and acute respiratory syndrome (ARDS) were treated with convalescent plasma from recently recovered patients.
Patients: All the five patients have common conditions: severe pneumonia with rapid progression, high viral load despite antiviral treatment, PAO2/F102 <300 and were on mechanical ventilation.
Donors: All the convalescent plasma donors previously had covid19 and had recovered atleast 10 days before the day of donation. They were all tested negative for SARS-CoV-2, hepatitis-C virus, HIV and syphilis at the time of blood donation. Following donation, 400 mL of plasma was obtained by apheresis and plasma was immediately transfused to the recipient.
Results: Following transfusion, they check the following parameters: body temperature; (SOFA) Score (range 0-24 with higher scores indicating more severe illness); viral load; titer of neutralizing antibodies; PAO2/F102.
- The body temperature returns to normal in 3 days in 4 of 5 patients.
- SOFA score decreased
- PAO2/F102 increased within 12 days.
- Viral loads decrease and became negative within 12 days.
- The SARS-CoV-2 specific neutralizing antibody titer increased from 40-60 to 80-320 in day 7.
- ARSD was also resolved in 4 patients at 12 days.
Of the five patients, 3 have been discharged from the hospital and 2 are in stable condition.
Conclusion: Administration of convalescent plasma containing neutralizing antibody improves the clinical status of the patients. However, it needs more clinical trials because of the limited sample size and nature of the study design (uncontrolled case).
Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. March 27, 2020. doi:10.1001/jama.2020.4783