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Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality.
Casadevall, Arturo; Dragotakes, Quigly; Johnson, Patrick W; Senefeld, Jonathon W; Klassen, Stephen A; Wright, R Scott; Joyner, Michael J; Paneth, Nigel; Carter, Rickey E.
  • Casadevall A; Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, United States.
  • Dragotakes Q; Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, United States.
  • Johnson PW; Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, United States.
  • Senefeld JW; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, United States.
  • Klassen SA; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, United States.
  • Wright RS; Department of Cardiology, Mayo Clinic, Rochester, United States.
  • Joyner MJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, United States.
  • Paneth N; Department of Epidemiology and Biostatistics and Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, United States.
  • Carter RE; Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, United States.
Elife ; 102021 06 04.
Article in English | MEDLINE | ID: covidwho-1278700
ABSTRACT

Background:

The US Food and Drug Administration authorized COVID-19 convalescent plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the USA.

Methods:

We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.

Results:

CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, p=0.002) between CCP usage per hospital admission and deaths occurring 2 weeks after admission, and this finding was robust to examination of deaths taking place 1, 2, or 3 weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.

Conclusions:

A strong inverse correlation between CCP use and mortality per admission in the USA provides population-level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.

Funding:

There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Variants Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: ELife.69866

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Variants Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: ELife.69866