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    A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia

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    BACKGROUND:Convalescent plasma is frequently administered to patients with Covid-19 and hasbeen reported, largely on the basis of observational data, to improve clinical outcomes.Minimal data are available from adequately powered randomized, controlled trials. METHODS:We randomly assigned hospitalized adult patients with severe Covid-19 pneumoniain a 2:1 ratio to receive convalescent plasma or placebo. The primary outcome wasthe patient?s clinical status 30 days after the intervention, as measured on a six-pointordinal scale ranging from total recovery to death. RESULTS:A total of 228 patients were assigned to receive convalescent plasma and 105 toreceive placebo. The median time from the onset of symptoms to enrollment inthe trial was 8 days (interquartile range, 5 to 10), and hypoxemia was the mostfrequent severity criterion for enrollment. The infused convalescent plasma had amedian titer of 1:3200 of total SARS-CoV-2 antibodies (interquartile range, 1:800 to1:3200]. No patients were lost to follow-up. At day 30 day, no significant differencewas noted between the convalescent plasma group and the placebo group in thedistribution of clinical outcomes according to the ordinal scale (odds ratio, 0.83(95% confidence interval [CI], 0.52 to 1.35; P=0.46). Overall mortality was 10.96%in the convalescent plasma group and 11.43% in the placebo group, for a risk difference of −0.46 percentage points (95% CI, −7.8 to 6.8). Total SARS-CoV-2 antibodytiters tended to be higher in the convalescent plasma group at day 2 after the intervention. Adverse events and serious adverse events were similar in the two groups. CONCLUSIONS:no significant differences were observed in clinical status or overall mortality between patients treated with convalescent plasma and those who received placebo.(PlasmAr ClinicalTrials.gov number, NCT04383535.)Fil: Simonovich, Ventura A.. Hospital Italiano. Departamento de Medicina. Servicio de Clinica Medica.; ArgentinaFil: Burgos Pratx, Leandro D.. Hospital Italiano. Departamento de Medicina. Servicio de Clinica Medica.; ArgentinaFil: Scibona, Paula. Hospital Italiano. Departamento de Medicina. Servicio de Clinica Medica.; ArgentinaFil: Beruto, Maria Valeria. No especifĂ­ca;Fil: Vallone, Miguel Gabriel. No especifĂ­ca;Fil: VĂĄzquez, C.. No especifĂ­ca;Fil: Savoy, N.. No especifĂ­ca;Fil: Giunta, Diego Hernan. No especifĂ­ca;Fil: PĂ©rez, L.G.. No especifĂ­ca;Fil: SĂĄnchez, M.L.. No especifĂ­ca;Fil: Gamarnik, Andrea Vanesa. Consejo Nacional de Investigaciones CientĂ­ficas y TĂ©cnicas. Oficina de CoordinaciĂłn Administrativa Parque Centenario. Instituto de Investigaciones BioquĂ­micas de Buenos Aires. FundaciĂłn Instituto Leloir. Instituto de Investigaciones BioquĂ­micas de Buenos Aires; ArgentinaFil: Ojeda, D.S.. No especifĂ­ca;Fil: Santoro, D.M.. No especifĂ­ca;Fil: Camino, P. J.. No especifĂ­ca;Fil: Antelo, S.. No especifĂ­ca;Fil: Rainero, K.. No especifĂ­ca;Fil: Vidiella, G. P.. No especifĂ­ca;Fil: Miyazaki, E. A.. No especifĂ­ca;Fil: Cornistein, W.. No especifĂ­ca;Fil: Trabadelo, O. A.. No especifĂ­ca;Fil: Ross, F. M.. No especifĂ­ca;Fil: Spotti, M.. No especifĂ­ca;Fil: Funtowicz, G.. No especifĂ­ca;Fil: Scordo, W. E.. No especifĂ­ca;Fil: Losso, M. H.. No especifĂ­ca;Fil: Ferniot, I.. No especifĂ­ca;Fil: Pardo, P. E.. No especifĂ­ca;Fil: Rodriguez, E.. No especifĂ­ca;Fil: Rucci, P.. No especifĂ­ca;Fil: Pasquali, J.. No especifĂ­ca;Fil: Fuentes, N. A.. No especifĂ­ca;Fil: Esperatti, M.. No especifĂ­ca;Fil: Speroni, G. A.. No especifĂ­ca;Fil: Nannini, Esteban. Consejo Nacional de Investigaciones CientĂ­ficas y TĂ©cnicas. Centro CientĂ­fico TecnolĂłgico Conicet - Rosario. Instituto de InmunologĂ­a Clinica y Experimental de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias MĂ©dicas. Instituto de InmunologĂ­a Clinica y Experimental de Rosario; ArgentinaFil: Matteaccio, A.. No especifĂ­ca;Fil: Michelangelo, H.G.. No especifĂ­ca;Fil: Follmann, D.. No especifĂ­ca;Fil: Lane, H. Clifford. No especifĂ­ca;Fil: Belloso, Waldo Horacio. Hospital Italiano. Departamento de Medicina. Servicio de Clinica Medica.; Argentin
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