Convalescent Plasma for COVID-19- is it Time to Say Goodbye? A Single-Center, Retrospective, Observational Study from Northern India
Rasika Setia
Department of Transfusion Medicine, Blk Superspecialty Hospital, India.
Mitu Dogra *
Department of Transfusion Medicine, Blk Superspecialty Hospital, India.
Gokhula Prasath Thangavel
Department of Transfusion Medicine, Blk Superspecialty Hospital, India.
Ramesh Yadav
Department of Transfusion Medicine, Blk Superspecialty Hospital, India.
Amena Ebadur Rahman
Department of Transfusion Medicine, Blk Superspecialty Hospital, India.
Atul Bhasin
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Rajesh Kumar Pande
Department of Critical Care, Blk Superspecialty Hospital, India.
Sandeep Nayar
Department of Chest and Respiratory Diseases, Blk Superspecialty Hospital, India.
R. K. Singal
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Anil Vardani
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Deepak Gargi Pande
Department of Internal Medicine, Blk Superspecialty Hospital, India.
R. N. Saini
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Tribhuvan GulatI
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Vivek Pal Singh
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Sunny Kalra
Department of Chest and Respiratory Diseases, Blk Superspecialty Hospital, India.
Gagan Anand
Department of Internal Medicine, Blk Superspecialty Hospital, India.
Manish Garg
Department of Chest and Respiratory Diseases, Blk Superspecialty Hospital, India.
Santosh Ghai
Department of Internal Medicine, Blk Superspecialty Hospital, India.
N. M. Agarwal
Department of Internal Medicine, Blk Superspecialty Hospital, India.
*Author to whom correspondence should be addressed.
Abstract
Background: COVID-19 pandemic continues threatening the world with no effective treatment to tackle the menace. Till date, there is conflicting evidence on efficacy of CP in reducing COVID-19 related mortality. The objective of this study was to see disease progression and 7, 14 and 28-day mortality after CP therapy and analyze CP efficacy with/without Remdesivir.
Materials and Methods: A retrospective single-centre observational study done from August 20, 2020, to 20 November 2020. Records of 294 COVID-19 patients with moderate to severe disease given CP therapy were analysed based on disease progression and length of hospital stay, further subcategorized on age, clinical profile, risk factors, ward/ICU, ventilatory support and co-administration of Remdesivir.
Results: Lowest 7-day mortality rate was seen within age group 20-40 years (0%) and was highest in ≥61 years (24.3%). 87 patients on ventilatory support showed higher 28day mortality (48.28%) compared to non-ventilated (10.14%), (P<0.00001). Lesser 7-day mortality was seen in early CP therapy ≤3 days of admission (P=0.01). Patients requiring ICU admission showed higher 14 and 28-day mortality compared to ward P=0.001%). Median (IQR) length of hospital stay from CP transfusion was shorter, 4 (3 to 9) days in group 2 (CP only) compared to 7 (4 to 12) days in group1 (CP+Remdesivir ).
Conclusion: CP therapy in ≤3 days of hospital admission in COVID-19 patients with moderate to severe infection not on ventilatory support showed reduction in mortality and length of hospital stay. Length of hospital stay was shorter in the CP-only group as compared to the CP+ Remdesivir group.
Keywords: convalescent plasma, COVID-19, ARDS, CP therapy