Early high antibody titre convalescent plasma for hospitalised COVID-19 patients: DAWn-plasma #MMPMID34446469
Devos T; Van Thillo Q; Compernolle V; Najdovski T; Romano M; Dauby N; Jadot L; Leys M; Maillart E; Loof S; Seyler L; Moonen M; Moutschen M; Van Regenmortel N; Arien KK; Barbezange C; Betrains A; Garigliany M; Engelen MM; Gyselinck I; Maes P; Schauwvlieghe A; Liesenborghs L; Belmans A; Verhamme P; Meyfroidt G
Eur Respir J 2022[Feb]; 59 (2): ? PMID34446469show ga
BACKGROUND: Several randomised clinical trials have studied convalescent plasma for coronavirus disease 2019 (COVID-19) using different protocols, with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralising antibody titres, at different time-points and severities of illness. METHODS: In the prospective multicentre DAWn-plasma trial, adult patients hospitalised with COVID-19 were randomised to 4 units of open-label convalescent plasma combined with standard of care (intervention group) or standard of care alone (control group). Plasma from donors with neutralising antibody titres (50% neutralisation titre (NT(50))) >/=1/320 was the product of choice for the study. RESULTS: Between 2 May 2020 and 26 January 2021, 320 patients were randomised to convalescent plasma and 163 patients to the control group according to a 2:1 allocation scheme. A median (interquartile range) volume of 884 (806-906) mL) convalescent plasma was administered and 80.68% of the units came from donors with neutralising antibody titres (NT(50)) >/=1/320. Median time from onset of symptoms to randomisation was 7 days. The proportion of patients alive and free of mechanical ventilation on day 15 was not different between both groups (convalescent plasma 83.74% (n=267) versus control 84.05% (n=137)) (OR 0.99, 95% CI 0.59-1.66; p=0.9772). The intervention did not change the natural course of antibody titres. The number of serious or severe adverse events was similar in both study arms and transfusion-related side-effects were reported in 19 out of 320 patients in the intervention group (5.94%). CONCLUSIONS: Transfusion of 4 units of convalescent plasma with high neutralising antibody titres early in hospitalised COVID-19 patients did not result in a significant improvement of clinical status or reduced mortality.
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Eur+Respir+J 2022 ; 59 (2): ?
