Regular article
Immunopathology and infectious diseases
Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma

https://doi.org/10.1016/j.ajpath.2020.05.014Get rights and content
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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has spread globally, and no proven treatments are available. Convalescent plasma therapy has been used with varying degrees of success to treat severe microbial infections for >100 years. Patients (n = 25) with severe and/or life-threatening COVID-19 disease were enrolled at the Houston Methodist hospitals from March 28, 2020, to April 14, 2020. Patients were transfused with convalescent plasma, obtained from donors with confirmed severe acute respiratory syndrome coronavirus 2 infection who had recovered. The primary study outcome was safety, and the secondary outcome was clinical status at day 14 after transfusion. Clinical improvement was assessed on the basis of a modified World Health Organization six-point ordinal scale and laboratory parameters. Viral genome sequencing was performed on donor and recipient strains. At day 7 after transfusion with convalescent plasma, nine patients had at least a one-point improvement in clinical scale, and seven of those were discharged. By day 14 after transfusion, 19 (76%) patients had at least a one-point improvement in clinical status, and 11 were discharged. No adverse events as a result of plasma transfusion were observed. Whole genome sequencing data did not identify a strain genotype-disease severity correlation. The data indicate that administration of convalescent plasma is a safe treatment option for those with severe COVID-19 disease.

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Supported by NIH grants AI146771-01 and AI139369-01; the Fondren Foundation, Houston Methodist Hospital and Research Institute (J.M.M.); National Institute of Allergy and Infectious Diseases/NIH, contract 75N93019C00050 (J.L. and G.C.I.); and Army Research Office Cooperative Agreement W911NF-12-1-0390 (J.D.G.).

Disclosures: None declared.