Outcome of SARS CoV-2 inpatients treated with convalescent plasma: One-year of data from the Veneto region (Italy) Registry

• Published in: European journal of internal medicine 2022-03, Vol.97, p.42-49
• Main Authors: De Silvestro, Giustina, Marson, Piero, La Raja, Massimo, Cattelan, Anna Maria, Guarnieri, Gabriella, Monticelli, Jacopo, Tiberio, Ivo, Vianello, Andrea, Gandini, Giorgio, Gessoni, Gianluca, Fiorin, Francesco, Sardella, Corrado, Astolfi, Laura, Saia, Mario
• Format: Article
• Language: English
• Subjects: Adult; Aged; Convalescent plasma; COVID-19 - therapy; Humans; Immunization, Passive; Inpatients; Mortality; Original; Registries; SARS-CoV-2; Treatment Outcome; Veneto region
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2021.12.023

•Treatment with anti-SARS-CoV-2 convalescent plasma (CCP) has been proven useful in a large series of inpatients, selected with well-defined clinical and radiological criteria, in the veneto region (Italy).•The greatest efficacy of CCP has been highlighted in elderly inpatients (≥75 years), who represented the majority of this series.•Adverse events related to CCP administration have been rare (0.4%) and mild in most cases.•Efficacy of CCP has been most evident when treating inpatients within the first three days of hospital admission. Convalescent plasma (CP) has been used worldwide to contrast SARS-CoV-2 infection. Since April 2020, it has also been used in the treatment of patients with COVID-19 in the Veneto region (Italy), along with all the other available drugs and therapeutic tools. Here we report data analysis and clinical results in 1,517 COVID-19 inpatients treated with CP containing high-titre neutralizing anti-SARS-CoV-2 antibodies (CCP). Mortality after 30 days of hospitalization has been considered primary outcome, by comparing patients treated with CCP vs all COVID-19 patients admitted to hospitals of the Veneto region in a one-year period (from April 2020 to April 2021). Adult inpatients with a severe form of COVID-19 have been enrolled, with at least one of the following inclusion criteria: 1) tachypnea with respiratory rate (RR) ≥ 30 breaths/min; 2) oxygen saturation (SpO2) ≤ 93% at rest and in room air; 3) partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ≤ 200 mmHg, 4) radiological picture and/or chest CT scan showing signs of interstitial disease and/or rapid progression of lung involvement. Patients received a maximum of three therapeutic fractions (TFs) of CCP with a neutralizing antibody titre of ≥ 1:160, administered over a period of 3–5 days. If TFs of CCP with titre ≥ 1:160 were unavailable, 2 with antibody titre of ≥ 1:80 have been administered. Of the 1,517 patients treated with CCP, 209 deceased at the 30-day follow-up (14%). Death was significantly associated with an older age (p