Convalescent plasma - An insight into a novel treatment of covid-19 ICU patients

Transfus Apher Sci. 2022 Dec;61(6):103497. doi: 10.1016/j.transci.2022.103497. Epub 2022 Jul 1.

Abstract

Introduction: Various therapies have been tried for Covid disease including the use of antivirals, steroids, monoclonal antibodies and convalescent plasma.

Method: The study was conducted on convalescent plasma transfused ICU patients. Part A of the study involves clinical outcomes based on gender, age, comorbidities, blood group,and the average length of stay. Part B investigates clinical outcomes in patients transfused with convalescent plasma before and after the November 2021 guidelines. Part C of the study includes patients in cytokine storm and the efficacy of tocilizumab in these patients.

Result: Out of the 326 ICU patients transfused with convalescent plasma the overall mortality was 152 (53.3 %). On comparing blood groups and clinical outcomes, a clinically significant result was found. A clinically significant association was also seen on comparing the clinical outcome of 18-50 years and 61-70 years age group and in female gender patients. The average number of ICU days had a positive impact on the overall patient survival. Out of the patients in 'cytokine storm' (n = 109), on day 20, the survival percentage in the non-Tocilizumab group showed a downward trend throughout. However, in the Tocilizumab group, the survival percentage remained stable throughout till around day 50.

Conclusion: Amongst the convalescent plasma transfused ICU patients, females, having blood group B, and an average length of stay of fewer than 20 days had a better chance of survival. The patients given tocilizumab and convalescent plasma had a better chance of survival compared to tocilizumab alone.

Keywords: Convalescent Plasma; Guidelines; ICU; Tocilizumab.

MeSH terms

  • Blood Group Antigens*
  • COVID-19 Serotherapy
  • COVID-19* / therapy
  • Cytokine Release Syndrome
  • Cytokines
  • Female
  • Humans
  • Immunization, Passive / adverse effects
  • Intensive Care Units
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Blood Group Antigens
  • Cytokines