ABSTRACT
0In the absence of effective countermeasures, human convalescent plasma has been widely used to treat severe acute respiratory syndrome coronavirus 2 including among patients with innate or acquired immunodeficiency. However, the association between COVID-19-associated mortality in patients with immunodeficiency and therapeutic use of convalescent plasma is unknown. We review clinical features and treatment protocols of COVID-19 patients with immunodeficiency after treatment with human convalescent plasma. We also discuss the time course and clinical features of recovery. These insights provide evidence for the need to develop a clear treatment protocol for COVID-19 patients with immunodeficiency and support the efficacy of convalescent plasma in patients with primary or secondary immunodeficiency.
ABSTRACT
To determine the effect of COVID-19 convalescent plasma on mortality, we aggregated patient outcome data from randomized clinical trials, matched control, case series, and case report studies. Fixed-effects analyses demonstrated that hospitalized COVID-19 patients transfused with convalescent plasma exhibited a ~57% reduction in mortality rate (10%) compared to matched-patients receiving standard treatments (22%; OR: 0.43, P < 0.001). These data provide evidence favouring the efficacy of human convalescent plasma as a therapeutic agent in hospitalized COVID-19 patients.
ABSTRACT
ImportanceThe novel coronavirus, SARS-CoV-2, is responsible for a world-wide pandemic. While the medical community understands the mode of viral transmission, less is known about how long viral shedding occurs once viral symptoms have resolved. ObjectiveTo determine how long the SARS-CoV-2 remains detectable following self-reporting of viral symptom resolution. DesignA cohort of 86 previously SARS-CoV-2 positive patients were re-tested for proof of viral recovery by nasal swab and nucleic acid amplification less than 28 days after self-reported symptom resolution. This study was approved by the University of Wisconsin Institutional Review Board. SettingA tertiary care center in a mid-size city utilizing a drive-through SAR-CoV-2 testing center. Participants86 previously confirmed SARS-CoV-2 positive individuals less than 28 days after self-reported resolution of symptoms evaluated as potential donors for COVID-19 convalescent plasma. InterventionParticipants underwent nasopharyngeal sampling and subsequent nucleic acid amplification for SARS-CoV-2 genes. Main OutcomeSARS-CoV-2 RNA in nasopharyngeal secretions detected by rtPCR. Results11/86 (13%) previously confirmed SARS-CoV-2 subjects were still positive at a median of 19 days (range 12-24 days) after symptom resolution. Older patients were more likely to be test-positive, and older positive patients had lower rtPCR CT values. Test-positive patients were not significantly different from test-negative patients with respect to days since symptom recovery. Conclusions and ResolutionThese results underscore the necessity of testing COVID-19 convalescent plasma donors less than 28 days after symptom resolution and suggests that COVID-19 positive patients may need to remain in quarantine beyond the recommended two weeks following "recovery." Trial Registrationn/a
