CHEST Guidelines-Neutralizing-COVID-19-Convalescent-Plasma-in-Adult

Neutralizing-COVID-19-Convalescent-Plasma-in-Adult

Pdf Summary

A clinical trial, titled "Neutralizing COVID-19 Convalescent Plasma in Adults Hospitalized With COVID-19," examined whether rigorously selected COVID-19 convalescent plasma containing neutralizing anti-SARS-CoV-2 antibodies improves outcomes in adults hospitalized with COVID-19. This multicenter, blinded, placebo-controlled trial enrolled 974 adults experiencing acute respiratory symptoms for 14 days or fewer. Participants were randomly assigned to receive either convalescent plasma or a placebo. The primary outcome was evaluated 14 days after infusion, utilizing a seven-category ordinal scale to measure clinical status, with secondary outcomes including 28-day mortality.<br /><br />The trial's findings showed no significant difference in clinical improvement between the plasma and placebo groups 14 days post-infusion (adjusted odds ratio [aOR], 1.04) or in 28-day mortality rates (aOR, 1.04). The study stratified patients by their endogenous antibody status at baseline and found no efficacy differences within these groups. Additionally, none of the 13 secondary outcomes demonstrated clinical benefits over the placebo.<br /><br />Results suggest that even high-quality neutralizing COVID-19 convalescent plasma does not improve clinical outcomes in hospitalized adults, regardless of serostatus. These outcomes were consistent across different duration phases, plasma with or without confirmed neutralizing activity, and symptomatic durations.<br /><br />The trial addressed prior critiques of convalescent plasma efficacy, ensuring rigorous selection based on neutralizing activity, while still achieving null results, aligning with the findings of other large randomized trials. This indicates that neutralizing convalescent plasma is not effective as a treatment strategy for hospitalized COVID-19 patients.<br /><br />Overall, the study concludes that COVID-19 convalescent plasma does not improve clinical outcomes in adults hospitalized with the virus, suggesting it is not a viable treatment under these conditions.

Keywords

COVID-19

convalescent plasma

clinical trial

hospitalized adults

neutralizing antibodies

placebo-controlled

clinical outcomes

randomized trial

treatment efficacy

respiratory symptoms