Comparison of safety and efficacy of convalescent plasma with fresh frozen plasma in severe covid-19 patients

BAJPAI, MEENU; MAHESHWARI, ASHISH; KUMAR, SURESH; CHHABRA, KARAN; KALE, PRATIBHA; NARAYANAN, ASHAD; GUPTA, AMITA; GUPTA, EKTA; TREHANPATI, NIRUPAMA; AGARWAL, RESHU; GUPTA, KAMINI; BHARDWAJ, ANKIT; ISLAM, MOJAHIDUL; SINGH, RAVINDER; YADAV, PUSHPA; KUMAR, GURESH; SARIN, SHIV K.

doi:10.1590/0001-3765202220210202

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HEALTH SCIENCES • An. Acad. Bras. Ciênc. 94 (4) • 2022 • https://doi.org/10.1590/0001-3765202220210202 copy

Comparison of safety and efficacy of convalescent plasma with fresh frozen plasma in severe covid-19 patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

background: Role of Convalescent plasma (COPLA) to treat severe COVID-19 is under investigation. We compared efficacy and safety of COPLA with fresh frozen plasma (FFP) in severe COVID-19 patients. Methods: One group received COPLA with standard medical care (n = 14), and another group received random donor FFP, as control with standard medical care (n = 15) in severe COVID-19 disease. Results: The proportion of patients free of ventilation at day seven were 78.5% in COPLA group, and 93.3 % in control group were not significant (p= 0.258). However, improved respiratory rate, O2 saturation, SOFA score, and Ct value were observed in the COPLA group. No serious adverse events were noticed by plasma transfusion in both groups.

Key words
COVID-19; convalescent plasma; donor plasmapheresis; ARDS; immunoglobulins; antibodies

Baseline parameters	Overall (n=29)	Convalescent Plasma group (n=14)	Fresh frozen Plasma group (n=15)	p-value
Mean Age (Years)	48.21 ± 9.79	48.14 ± 9.05	48.27 ± 10.75	0.96
Male (n, %)	22 (75.86)	11 (78.6)	11 (73.3)	1.0
Chest X-ray changes (n, %)	25 (86.20)	12 (85.7)	13 (86.67)	0.94
BMI	26.31 ± 2.29	26.28 ± 2.52	26.13 ± 2.22	0.78
Respiratory rate/min	34.9 ± 2.55	35.36 ± 2.65	34.47 ± 2.47	0.38
PaO2 (mmHg)	61.76 ± 4.96	62.71 ± 3.87	61.13 ± 5.74	0.58
O2 Saturation (%)	85.03 ± 4.03	85 ± 4.29	85.07 ± 3.92	0.53
FiO2 (mmHg)	0.38 ± 0.04	0.38 ± 0.03	0.38 ± 0.04	0.89
PaO2/FiO2 ratio	162.92 ± 13.77	164.92 ± 15.85	161.06 ± 11.77	0.43
Baseline Neutrophils (N) (per microliter)	3375 (2626, 6928)	3083 (2700, 7512)	3782 (2432,7520)	0.87
Baseline Lymphocytes (L) (per microliter)	968 (758, 1874)	935 (747, 1872)	1240 (760, 1950)	0.90
N / L ratio	3.8(3.37, 4.67)	3.67 (3.26, 4.46)	4(3.5, 5)	0.60
Platelet count (in lakh per microliter)	1.8 ± 1.20	2.05 ± 1.42	1.58 ± 0.95	0.49
Baseline Ct value	31.91 ± 3.44	30.83 ± 4.07	32.93 ± 2.46	0.12
SOFA Score	7.44 ± 1.86	7.71 ± 1.59	7.20 ± 2.11	0.32

Variable	Convalescent plasma (n=14)	Normal plasma (n=15)	p-value
Median Reduction in Respiratory Rate/min at 48 hours	-6.5 (-10.25, -5)	-3 (-5,-1)	0.004
Median Reduction in Respiratory Rate/min at 7 days	-14.5 (-18.75, -13)	-10 (-14,-9)	0.008
Median Improvement in O2 Saturation at 48 hour	6.5 (5, 7.25)	2 (1, 2)	<0.001
Median Improvement in O2 Saturation at 7 days	10 (8.2, 11)	7.5(4.75, 9.25)	0.026
Mechanical Ventilation within 7 days (n) %	3 (21.4)	1 (6.7)	0.258
Median reduction in SOFA Score 48 hours	-2 (-2.25,-1)	-1 (-1, 0.0)	0.01
Median Reduction in SOFA Score 7 days	-5 (-6.5,-4.0)	-3 (-5.25,-2.75)	0.04
Median improvement in PaO2/FiO2 at 48 hour	41.94 (1.25, 55.58)	5.55 (-9.318, 11.11)	0.009
Median improvement in PaO2/FiO2 at 7 days	231.15(183.37, 245.20)	77.01 (56.93, 96.20)	<0.001
Median ICU stay	5 (4,7)	5 (4, 5.7)	0.72
Mean duration of Hospital stay (days)	12.07 ± 4.1	16.07 ± 5.6	0.08
Increase in S1 RBD IgG antibody titre post transfusion	12 (85.7%)	4(26.7%)	0.001
Median Improvement in Lymphocyte count at 7 days	896.5 (524.5, 1351.5)	105(-8, 523)	0.15
Transfusion reactions (n)	1 (7.1%)	1 (6.7%)	1
Median Improvement in Ct value at 7 days	7.7 (3.4, 9.2)	5.15 (3.3, 6.27)	0.11
Mortality till 7 days (n) %	2 (14.28%)	1 (6.7%)	0.60
Mortality till 28 days (n) %	3 (21.4%)	1 (6.7%)	0.25

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[1] Correspondence to: Shiv Kumar Sarin E-mail: shivsarin@gmail.com