Early Plasma Therapy Benefits Vulnerable COVID-19 Patients

TOPLINE:

High-titre convalescent plasma therapy given within a week of symptom onset reduced hospitalisation and death and was well tolerated in immunocompromised patients with mild COVID-19.

METHODOLOGY:

• This randomised trial conducted across Germany, France, and the Netherlands from April 2022 to November 2023 examined the safety and efficacy of high-titre COVID-19 plasma in 117 immunocompromised patients (median age, 57 years; 58.1% men) with mild COVID-19.
• Participants were randomly assigned to receive either standard care alone or standard care plus two units (250-300 mL each) of blood group–compatible convalescent plasma given within 7 days of symptom onset.
• Plasma was obtained from convalescent, vaccinated donors with very high levels of SARS-CoV-2 antibodies (≥ 20,000 IU/mL).
• Most patients (65.8%) had received four doses of SARS-CoV-2 vaccines.
• The primary endpoint was the proportion of patients who were hospitalised for progressive COVID-19 symptoms or who died by day 28 after randomisation.

TAKEAWAY:

• The primary endpoint occurred in 8.6% of patients in the standard care group, whereas it was not observed in any patients in the convalescent plasma group (difference −8.6%; P = .027).
• Serious adverse events occurred in 20% of patients in the convalescent plasma group vs 36% of patients in the standard care group, with none related to any of the study interventions.
• The serum concentrations of anti–SARS-CoV-2 neutralising antibodies and the neutralisation of the wildtype virus did not differ significantly between the groups during later follow-up visits.

IN PRACTICE:

“The data from the COVIC-19 trial shows that a measurable passive transfer of SARS-CoV-2 antibodies was possible by CCP [COVID-19 convalescent plasma] even given the vaccine-induced immunisation,” the authors wrote.

SOURCE:

This study was led by Simone Hoffmann, Institute of Clinical Transfusion Medicine and Immunogenetics, University of Ulm, Ulm, and Eva Schrezenmeier, Charité-Universitätsmedizin Berlin, Berlin, Germany. It was published online on February 27, 2025, in eBioMedicine.

LIMITATIONS:

This study had a small sample size, a fragility index of 1, and possible bias due to its open-label design.

DISCLOSURES:

This study was supported by grants from the European Union’s Horizon 2020 Programme, the German Federal Ministry of Education and Research, and ZonMw, the Netherlands Organisation for Health Research and Development. Some authors reported being employees of blood transfusion companies or receiving grants, consulting fees, or honoraria from various pharmaceutical and healthcare companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.