Treatment of COVID-19 Patients with Convalescent Plasma

Authors: Salazar, E, Perez, KK, Ashraf, M, Chen, J, Castillo, B, Christensen, PA, Eubank, T, Bernard, DW, Eagar, TN, Long, SW, Subedi, S, Olsen, RJ, Leveque, C, Schwartz, MR, Dey, M, Chavez-East, C. Rogers, J, Shehabeldin, A, Joseph, D, Williams, G, Thomas, K, Masud, F, Talley, C, Dlouhy, KG, Lopez, BV, Hampton, C, Lavinder, J, Gollihar, JD, Maranhao, AC, Ippolito, GC, Saavedra, MO, Cantu, CC, Yerramilli, P, Pruitt, L, and Musser, JM.

Publication: Am.J.Pathol.; May 2020

Affiliations: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York; Department of Pharmacy, Houston Methodist Hospital, Houston, Texas; Division of Infectious Diseases, Department of Clinical Medicine, Houston Methodist Hospital, Houston, Texas; Academic Office of Clinical Trials, Houston Methodist Research Institute, Houston, Texas; Department of Molecular Biosciences, University of Texas at Austin, and Department of Oncology, Dell Medical School, University of Texas at Austin, Austin, Texas; CCDC Army Research Laboratory-South, University of Texas at Austin, Austin, Texas; Center for Molecular and Translational Human Infectious Diseases, Houston Methodist Research Institute, Houston, Texas.

Abstract: COVID-19 disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-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 more than 100 years. Patients (n = 25) with severe and/or life-threatening COVID-19 disease were enrolled at the Houston Methodist hospitals from March 28 – April 14, 2020. Patients were transfused with convalescent plasma obtained from donors with confirmed SARS-CoV-2 infection and had recovered. The primary study outcome was safety, and the secondary outcome was clinical status at day 14 post-transfusion. Clinical improvement was assessed based on a modified World Health Organization 6-point ordinal scale and laboratory parameters. Viral genome sequencing was performed on donor and recipient strains. At day 7 post-transfusion with convalescent plasma, nine patients had at least a 1-point improvement in clinical scale, and seven of those were discharged. By day 14 post-transfusion, 19 (76%) patients had at least a 1-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.