Effect of convalescent plasma in the treatment of severe acute respiratory distress syndrome caused by COVID-19 infection

Abstract

Introduction/Objective Convalescent plasma (CP) has been used in the past to treat several infectious diseases. It was hypothesized that CP could have a positive impact on severely ill patients with COVID-19 infection. The aim of the study was to present the results of CP application in patients with severe acute respiratory distress syndrome (ARDS) caused by COVID-19 infection.

Methods This is an observational study of critically ill patients who received CP according to the National Protocol for the Treatment of COVID-19 Infection at the University Clinical Center of Vojvodina in Novi Sad, Serbia, in 2020. Clinical outcomes were monitored before and after CP administration.

Results A total of 14 patients with severe life-threatening COVID-19 infection were included in the study. The patients age ranged 53–79 years. Most of them had two or more comorbidities, and more than half of them had blood type A Rh positive. Prior to CP administration, all patients received antibiotic therapy for severe pneumonia, corticosteroids, and anticoagulant therapy. Twelve out of 14 patients (85.7%) required endotracheal intubation and mechanical ventilation of the lungs, while two patients were on non-invasive mechanical ventilation. CP was administered 2–13 days after the confirmed diagnosis of COVID-19. The PaO2/FiO2 ratio before CP administration ranged 49.5–78.6. Twelve patients (85.7%) died during the course of the study.

Conclusion The use of CP in cases of severe ARDS caused by COVID-19 infection does not impact survival or lead to other forms of clinical improvement.

Keywords: COVID-19; acute respiratory distress syndrome; convalescent plasma