Convalescent Plasma Therapy in Critically İll COVID‑19 Patients: A Retrospective Cohort Study

Abstract

Background: Convalescent plasma (CP) therapy can be defined as a passive immunity transfer approach involving the administration of  plasma for therapeutic purposes to inpatients hospitalized due to an active virus infection. Passive immunity antibodies can reduce target  organ damage and directly neutralize the responsible pathogens. A limited number of studies on the use of CP have reported that  critically ill patients can benefit from CP therapy. 

Aim: We aimed in this study as the outcomes of CP therapy in critically ill  coronavirus disease 2019 (COVID‑19) patients in intensive care unit (ICU) and determine the differences between the recovery and  mortality groups. 

Patients and Methods: This retrospective design study involved critically ill patients who were diagnosed with  COVID‑19 pneumonia or who were suspected of having COVID‑19 in the ICU between April 1, 2020, and June 1, 2020. Comorbidity of  patients, respiratory findings, hemodynamic data, laboratory data, and poor prognostic measures were compared between mortality and  recovery group. 

Results: Convalescent plasma (CP) therapy was supplied for 41 (13.58%) patients in total of 302 COVID‑19 patients. Twenty‑nine patients were died in total of 41 COVID‑19 patients who supplied CP therapy. The mortality rate is 70.73% in CP therapy.  There was a significantly higher incidence (P < 0.021) of invasive mechanical ventilation (IMV) and significantly lower mean arterial  pressure (MAP) values in mortality group (P < 0.05). There were significantly higher NLR values (P < 0.05), lower platelet count (P < 0.05), lower of glomerular filtration rate (GFR) level (P < 0.05), higher creatinine values (P < 0.05), higher lactate dehydrogenase (LDH) levels (P <  0.05), higher D‑dimer levels (P < 0.05), higher level of pro‑brain natriuretic peptide (BNP) (P = 0.000), rate of fever (P = 0.031), arrythmia  (P = 0.024), and transfusion‑associated circulatory overload (TACO) (P = 0.008) were more often in mortality group. 

Conclusion:  Convalescent plasma therapy seems not useful in critically ill COVID‑19 patients.