Use of COVID-19 Convalescent Plasma for Treatment of Symptomatic SARS-CoV-2 Infection at a Children’s Hospital: A Contribution to a Still Inadequate Body of Evidence
Antonio Arrieta,
Alvaro E. Galvis,
Stephanie Osborne,
Tricia Morphew,
Karen Imfeld,
Claudia Enriquez,
Janet Hoang,
Marcia Swearingen,
Delma J. Nieves,
Negar Ashouri,
Jasjit Singh,
Diane Nugent
Affiliations
Antonio Arrieta
Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
Alvaro E. Galvis
Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
Stephanie Osborne
Research Administration, CHOC Children’s Hospital, Orange, CA 92868, USA
Tricia Morphew
Morphew Consulting, LLC, CHOC Research Institute, CHOC Children’s Hospital, Orange, CA 92868, USA
Karen Imfeld
Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
Claudia Enriquez
Research Administration, CHOC Children’s Hospital, Orange, CA 92868, USA
Janet Hoang
Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
Marcia Swearingen
Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
Delma J. Nieves
Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
Negar Ashouri
Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
Jasjit Singh
Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
Diane Nugent
Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
Data on COVID-19 convalescent plasma (CCP) safety and efficacy in children and young adults are limited. This single-center prospective, open-label trial evaluates CCP safety, neutralizing antibody kinetics, and outcomes in children and young adults with moderate/severe COVID-19 (April 2020–March 2021). A total of 46 subjects received CCP; 43 were included in the safety analysis (SAS); 7.0% 19 years old; 28 were included in the antibody kinetic analysis (AbKS); 10.7% 19 years old. No adverse events occurred. The median COVID-19 severity score improved (5.0 pre-CCP to 1.0 by day 7; p < 0.001). A rapid increase in the median percentage of inhibition was observed in AbKS (22.5% (13.0%, 41.5%) pre-infusion to 52% (23.7%, 72%) 24 h post-infusion); a similar increase was observed in nine immune-competent subjects (28% (23%, 35%) to 63% (53%, 72%)). The inhibition percentage increased until day 7 and persisted at 21 and 90 days. CCP is well tolerated in children and young adults, providing rapid and robust increased antibodies. CCP should remain a therapeutic option for this population for whom vaccines are not fully available and given that the safety and efficacy of existing monoclonal antibodies and antiviral agents have not been established.
