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Safety and Antibody Kinetics of COVID-19 Convalescent Plasma for the Treatment of Moderate to Severe Cases of SARS-CoV-2 Infection in Pediatric Patients.
Arrieta, Antonio; Galvis, Alvaro E; Morphew, Tricia; Ehwerhemuepha, Louis; Osborne, Stephanie; Enriquez, Claudia; Imfeld, Karen; Hoang, Janet; Nieves, Delma; Ashouri, Negar; Singh, Jasjit; Nugent, Diane.
  • Arrieta A; From the CHOC Children's Hospital, Division of Infectious Diseases, Orange, California.
  • Galvis AE; Department of Pediatrics, University of California, Irvine, California.
  • Morphew T; From the CHOC Children's Hospital, Division of Infectious Diseases, Orange, California.
  • Ehwerhemuepha L; Department of Pediatrics, University of California, Irvine, California.
  • Osborne S; CHOC Children's Hospital, Orange, California; Morphew Consulting, LLC.
  • Enriquez C; CHOC Children's Hospital, Health Care Informatics, Orange, California.
  • Imfeld K; CHOC Children's Hospital of Orange County, Research Administration, Orange, California.
  • Hoang J; CHOC Children's Hospital of Orange County, Research Administration, Orange, California.
  • Nieves D; CHOC Children's Hospital, Division of Hematology, Orange, California.
  • Ashouri N; CHOC Children's Hospital, Division of Hematology, Orange, California.
  • Singh J; From the CHOC Children's Hospital, Division of Infectious Diseases, Orange, California.
  • Nugent D; Department of Pediatrics, University of California, Irvine, California.
Pediatr Infect Dis J ; 40(7): 606-611, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1709106
ABSTRACT

BACKGROUND:

Therapies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its life-threatening respiratory infection coronavirus disease 2019 (COVID-19) have been evaluated, including COVID-19 convalescent plasma (CCP). Multiple large reports of CCP treatment in adults exist. Pediatric data on CCP safety and efficacy are limited.

METHODS:

Single-center prospective, open-label trial looking at safety, antibody kinetics and outcomes of CCP (10 mL/kg, max 1 unit) treatment for COVID-19 in hospitalized pediatric patients with moderate to severe disease or at high-risk for serious illness.

RESULTS:

Thirteen patients were enrolled. No infusion-related adverse events occurred. No hematologic or metabolic adverse events were noted during hospitalization or at 3-weeks. Ten patients had clinical improvement by day 7 (WHO eight-category ordinal severity scale for COVID-19). Following CCP, anti-SARS-CoV-2 anti-nucleocapsid IgG increased significantly at 24 hours and high levels were sustained at 7- and 21-days. Transient IgM response was noted. Twelve patients (92.3%) were discharged home, 9 (75%) by day 7 post-CCP. One remained on invasive ventilatory support 42 days after CCP and was eventually discharged to an intermediate care facility. The single patient death was retrospectively confirmed to have had brain death before CCP.

CONCLUSION:

CCP was well tolerated in pediatric patients, resulted in rapid antibody increase, and did not appear to interfere with immune responses measured at 21 days. More pediatric data are necessary to establish the efficacy of CCP, but our data suggest benefit in moderate to severe COVID-19 when used early. Other immunologic or antiviral interventions may be added as supported by emerging data.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Pediatr Infect Dis J Journal subject: Communicable Diseases / Pediatrics Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Pediatr Infect Dis J Journal subject: Communicable Diseases / Pediatrics Year: 2021 Document Type: Article