In this preliminary uncontrolled case series of 5 critically ill patients with COVID-19 and ARDS, convalescent plasma containing neutralizing antibody showed promising results in treating severe cases. These observations require evaluation in clinical trials.
We would really like to have a treatment for COVID-19. This preliminary study sought to determine whether a plasma transfusion from recovered patients may help critically ill patients with severe infections.
The authors describe a case series of 5 critically ill patients with laboratory-confirmed COVID-19 and acute respiratory distress syndrome (ARDS) who had:
- Severe pneumonia with rapid progression
- Continuously high viral load despite antiviral treatment
- Pao2/Fio2 <300
- Mechanical ventilation.
They were all treated with convalescent plasma transfusion with a SARS-CoV-2–specific antibody (IgG) binding titer greater than 1:1000 and a neutralization titer greater than 40 that had been obtained from 5 patients who recovered from COVID-19.
After plasma transfusion, body temperature normalized within three days in 4/5 patients, and Pao2/Fio2 increased within 12 days. Viral loads decreased and became negative 12 days after the transfusion, and SARS-CoV-2–specific ELISA and neutralizing antibody titers increased. ARDS resolved in four patients at 12 days after transfusion, and three patients were weaned from mechanical ventilation within two weeks of treatment.
Three of the five patients were discharged from the hospital, and the other two are in stable condition at 37 days after transfusion.
This is an early study, and more needs to be done, but it’s a welcome first step.