JCI Insight (Mar 2021)

Clinical and laboratory evaluation of patients with SARS-CoV-2 pneumonia treated with high-titer convalescent plasma

  • Michele L. Donato,
  • Steven Park,
  • Melissa Baker,
  • Robert Korngold,
  • Alison Morawski,
  • Xue Geng,
  • Ming Tan,
  • Andrew Ip,
  • Stuart Goldberg,
  • Scott Rowley,
  • Kar Chow,
  • Emily Brown,
  • Joshua Zenreich,
  • Phyllis McKiernan,
  • Kathryn Buttner,
  • Anna Ullrich,
  • Laura Long,
  • Rena Feinman,
  • Andrea Ricourt,
  • Marlo Kemp,
  • Mariefel Vendivil,
  • Hyung Suh,
  • Bindu Balani,
  • Cristina Cicogna,
  • Rani Sebti,
  • Abdulla Al-Khan,
  • Steven Sperber,
  • Samit Desai,
  • Stacey Fanning,
  • Danit Arad,
  • Ronaldo Go,
  • Elizabeth Tam,
  • Keith Rose,
  • Sean Sadikot,
  • David Siegel,
  • Martin Gutierrez,
  • Tatyana Feldman,
  • Andre Goy,
  • Andrew Pecora,
  • Noa Biran,
  • Lori Leslie,
  • Alfred Gillio,
  • Sarah Timmapuri,
  • Michele Boonstra,
  • Sam Singer,
  • Sukhdeep Kaur,
  • Ernest Richards,
  • David S. Perlin

Journal volume & issue
Vol. 6, no. 6

Abstract

Read online

Here, we report on a phase IIa study to determine the intubation rate, survival, viral clearance, and development of endogenous Abs in patients with COVID-19 pneumonia treated with convalescent plasma (CCP) containing high levels of neutralizing anti–SARS-CoV-2 Abs. Radiographic and laboratory evaluation confirmed all 51 treated patients had COVID-19 pneumonia. Fresh or frozen CCP from donors with high titers of neutralizing Abs was administered. The nonmechanically ventilated patients (n = 36) had an intubation rate of 13.9% and a 30-day survival rate of 88.9%, and the overall survival rate for a comparative group based on network data was 72.5% (1625/2241). Patients had negative nasopharyngeal swab rates of 43.8% and 73.0% on days 10 and 30, respectively. Patients mechanically ventilated had a day-30 mortality rate of 46.7%; the mortality rate for a comparative group based on network data was 71.0% (369/520). All evaluable patients were found to have neutralizing Abs on day 3 (n = 47), and all but 1 patient had Abs on days 30 and 60. The only adverse event was a mild rash. In this study on patients with COVID-19 disease, we show therapeutic use of CCP was safe and conferred transfer of Abs, while preserving endogenous immune response.

Keywords