AUTHOR=Kurtz Pedro , Righy Cassia , Gadelha Monica , Bozza Fernando A. , Bozza Patricia T. , Gonçalves Bruno , Bastos Leonardo S. L. , Vale Andre M. , Higa Luiza M. , Castilho Leda , Monteiro Fabio L. , Charris Nestor , Fialho Fernanda , Turon Ricardo , Guterres Alexandro , Lyra Miranda Renan , de Azeredo Lima Carlos Henrique , de Caro Vanessa , Prazeres Marco Aurelio , Ventura Nina , Gaspari Clara , Miranda Fabio , Jose da Mata Paulo , Pêcego Margarida , Mateos Sheila , Lopes Maria Esther , Castilho Shirley , Oliveira Álvaro , Boquimpani Carla , Rabello Andréa , Lopes Josiane , Neto Orlando Conceição , Ferreira Orlando da C. , Tanuri Amilcar , Filho Paulo Niemeyer , Amorim Luiz 

TITLE=Effect of Convalescent Plasma in Critically Ill Patients With COVID-19: An Observational Study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.630982

DOI=10.3389/fmed.2021.630982

ISSN=2296-858X

ABSTRACT=Background: Convalescent plasma is a potential therapeutic option for critically ill patients with coronavirus disease 19 (COVID-19), yet its efficacy remains to be determined. The aim was to investigate the effects of convalescent plasma (CP) in critically ill patients with COVID-19.
Methods: This was a single-center prospective observational study conducted in Rio de Janeiro, Brazil, from March 17th to May 30th, with final follow-up on June 30th. We included 113 laboratory-confirmed COVID-19 patients with respiratory failure. Primary outcomes were time to clinical improvement and survival within 28 days. Secondary outcomes included behavior of biomarkers and viral loads. Kaplan Meier analyses and Cox proportional-hazards regression using propensity score with inverse-probability weighing were performed. 
Results: 41 patients received CP and 72 received standard of care (SOC). Median age was 61 years (IQR 48-68), disease duration was 10 days (IQR 6-13), and 86% were mechanically ventilated. At least 29 out of 41CP-recipients had baseline IgG titers >= 1:1,080. Clinical improvement within 28 days occurred in 19 (46%) CP-treated patients, as compared to 23 (32%) in the SOC group (adjusted hazard ratio [aHR] 0.91 [0.49-1.69]). There was no significant change in 28-day mortality (CP 49% vs SOC 56%; aHR 0.90 [0.52-1.57]). Biomarker assessment revealed reduced inflammatory activity and increased lymphocyte count after CP.
Conclusions: In this study, CP was not associated with clinical improvement or increase in 28-day survival. However, our study may have been underpowered and included patients with high IgG titers and life-threatening disease.