tetano
Editor, Senior Moderator
J Med Virol
. 2024 Apr;96(4):e29603.
doi: 10.1002/jmv.29603. Convalescent plasma transfusion for immunocompromised viremic patients with COVID-19: A retrospective multicenter study
Marjolaine Destremau[SUP] 1 [/SUP], Hélène Chaussade[SUP] 1 [/SUP], Victor Hemar[SUP] 1 [/SUP], Mathilde Beguet[SUP] 2 [/SUP], Pantxika Bellecave[SUP] 3 [/SUP], Elodie Blanchard[SUP] 4 [/SUP], Amaury Barret[SUP] 5 [/SUP], Gaelle Laboure[SUP] 6 [/SUP], Claire Vasco-Moynet[SUP] 7 [/SUP], Flore Lacassin[SUP] 8 [/SUP], Eloïse Morisse[SUP] 9 [/SUP], Claire Aguilar[SUP] 10 [/SUP], Xavier Lafarge[SUP] 2 11 [/SUP], Marie-Edith Lafon[SUP] 3 [/SUP], Fabrice Bonnet[SUP] 1 12 [/SUP], Nahéma Issa[SUP] 13 [/SUP], Fabrice Camou[SUP] 13 [/SUP]
Affiliations
This study aims to assess the safety, virological, and clinical outcomes of convalescent plasma transfusion (CPT) in immunocompromised patients hospitalized for coronavirus disease 2019 (COVID-19). We conducted a retrospective multicenter cohort study that included all immunosuppressed patients with COVID-19 and RNAemia from May 2020 to March 2023 treated with CPT. We included 81 patients with hematological malignancies (HM), transplants, or autoimmune diseases (69% treated with anti-CD20). Sixty patients (74%) were vaccinated, and 14 had pre-CPT serology >264 BAU/mL. The median delay between symptom onset and CPT was 23 days [13-31]. At D7 post-CPT, plasma PCR was negative in 43/64 patients (67.2%), and serology became positive in 25/30 patients (82%). Post-CPT positive serology was associated with RNAemia negativity (p < 0.001). The overall mortality rate at D28 was 26%, being higher in patients with non-B-cell HM (62%) than with B-cell HM (25%) or with no HM (11%) (p = 0.02). Patients receiving anti-CD20 without chemotherapy had the lowest mortality rate (8%). Positive RNAemia at D7 was associated with mortality at D28 in univariate analysis (HR: 3.05 [1.14-8.19]). Eight patients had adverse events, two of which were severe but transient. Our findings suggest that CPT can abolish RNAemia and ameliorate the clinical course in immunocompromised patients with COVID-19.
Keywords: SARS coronavirus; combination therapy; disease control; infection; virus classification.
. 2024 Apr;96(4):e29603.
doi: 10.1002/jmv.29603. Convalescent plasma transfusion for immunocompromised viremic patients with COVID-19: A retrospective multicenter study
Marjolaine Destremau[SUP] 1 [/SUP], Hélène Chaussade[SUP] 1 [/SUP], Victor Hemar[SUP] 1 [/SUP], Mathilde Beguet[SUP] 2 [/SUP], Pantxika Bellecave[SUP] 3 [/SUP], Elodie Blanchard[SUP] 4 [/SUP], Amaury Barret[SUP] 5 [/SUP], Gaelle Laboure[SUP] 6 [/SUP], Claire Vasco-Moynet[SUP] 7 [/SUP], Flore Lacassin[SUP] 8 [/SUP], Eloïse Morisse[SUP] 9 [/SUP], Claire Aguilar[SUP] 10 [/SUP], Xavier Lafarge[SUP] 2 11 [/SUP], Marie-Edith Lafon[SUP] 3 [/SUP], Fabrice Bonnet[SUP] 1 12 [/SUP], Nahéma Issa[SUP] 13 [/SUP], Fabrice Camou[SUP] 13 [/SUP]
Affiliations
- PMID: 38619025
- DOI: 10.1002/jmv.29603
This study aims to assess the safety, virological, and clinical outcomes of convalescent plasma transfusion (CPT) in immunocompromised patients hospitalized for coronavirus disease 2019 (COVID-19). We conducted a retrospective multicenter cohort study that included all immunosuppressed patients with COVID-19 and RNAemia from May 2020 to March 2023 treated with CPT. We included 81 patients with hematological malignancies (HM), transplants, or autoimmune diseases (69% treated with anti-CD20). Sixty patients (74%) were vaccinated, and 14 had pre-CPT serology >264 BAU/mL. The median delay between symptom onset and CPT was 23 days [13-31]. At D7 post-CPT, plasma PCR was negative in 43/64 patients (67.2%), and serology became positive in 25/30 patients (82%). Post-CPT positive serology was associated with RNAemia negativity (p < 0.001). The overall mortality rate at D28 was 26%, being higher in patients with non-B-cell HM (62%) than with B-cell HM (25%) or with no HM (11%) (p = 0.02). Patients receiving anti-CD20 without chemotherapy had the lowest mortality rate (8%). Positive RNAemia at D7 was associated with mortality at D28 in univariate analysis (HR: 3.05 [1.14-8.19]). Eight patients had adverse events, two of which were severe but transient. Our findings suggest that CPT can abolish RNAemia and ameliorate the clinical course in immunocompromised patients with COVID-19.
Keywords: SARS coronavirus; combination therapy; disease control; infection; virus classification.