Transfusion of convalescent plasma promises mortality benefits in immunocompromised COVID-19 patients

Mayo Clinic: A recent Original Investigation for Infectious Diseases published in JAMA Network Open has mentioned that convalescent plasma is tied to mortality benefits to hospitalised patients with primary or secondary immunosuppression and COVID-19.

Immunocompromised patients have a higher risk for morbidity and mortality associated with COVID-19. They mount antibody responses less frequently to vaccines. To treat COVID-19, neutralizing anti-spike monoclonal-antibody treatment has been used, but evolutions of SARS-CoV-2 have been related to monoclonal antibody-resistant SARS-CoV-2 variants and greater virulence and transmissibility of SARS-CoV-2. COVID-19 convalescent plasma has increased therapeutically based on the presumption that plasma contains antibodies to SARS-CoV-2, which are potentially therapeutic and can be transferred passively to the recipient.

What is the pooled evidence in this context?

Investigating further, a researchers team did a study to assess the growing reports of clinical experiences of COVID-19 immunocompromised patients treated with COVID-19 convalescent plasma transfusion. The lead researcher was Jonathon W.Senefeld, PhD. The study points are:

• The researchers selected relevant RCTs, matched cohort studies, and case reports or series

• Four hundred sixty-two unique records were yielded in the electronic search, and 199 were considered for full-text screening.

• All-cause mortality after COVID-19 convalescent plasma transfusion was the prespecified endpoint.

• The exploratory subgroup analyses were based on putative factors related to the potential mortality benefit of convalescent plasma.

• The review and meta-analysis included the following:

 3 RCT enrolled 1487 participants.

 Five matched cohort studies

 13 uncontrolled large case series enrolled 358 participants.

 125 case report series enrolled 265 participants.

• Transfusion of COVID-19 convalescent plasma decreased mortality than the control cohort for the amalgam of both RCT and matched cohort studies having a risk ratio [RR] of 0.63

To conclude, the researchers encourage using therapeutic convalescent plasma in COVID-19 patients with immunosuppression (primary or secondary); there remains a lack of well-controlled, published data in these important patient populations.

Further investigations are warranted in this context.

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