Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults

Libster et al., NEJM, doi:10.1056/NEJMoa2033700, INFANT-COVID-19, NCT04479163

Jan 2021

RCT 160 patients >=65 with symptom onset <72 hours, 80 treated with convalescent plasma, showing lower progression to severe disease with treatment.

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risk of death, 50.0% lower, RR 0.50, p = 0.43, treatment 2 of 80 (2.5%), control 4 of 80 (5.0%), NNT 40.

risk of mechanical ventilation, 50.0% lower, RR 0.50, p = 0.43, treatment 2 of 80 (2.5%), control 4 of 80 (5.0%), NNT 40.

risk of ICU admission, 67.0% lower, RR 0.33, p = 0.17, treatment 2 of 80 (2.5%), control 6 of 80 (7.5%), NNT 20.

risk of progression, 48.0% lower, RR 0.52, p = 0.03, treatment 13 of 80 (16.2%), control 25 of 80 (31.2%), NNT 6.7.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Libster et al., 6 Jan 2021, Double Blind Randomized Controlled Trial, Argentina, peer-reviewed, 56 authors, study period 4 June, 2020 - 25 October, 2020, trial NCT04479163 (history) (INFANT-COVID-19).

This Paper Conv. Plasma All

Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults

Romina Libster, Gonzalo Pérez Marc, Diego Wappner, Silvina Coviello, Alejandra Bianchi, Virginia Braem, Ignacio Esteban, Mauricio T Caballero, Cristian Wood, Mabel Berrueta, Aníbal Rondan, Gabriela Lescano, Pablo Cruz, Yvonne Ritou, Valeria Fernández Viña, Damián Álvarez Paggi, Sebastián Esperante, Adrián Ferreti, Gastón Ofman, Álvaro Ciganda, Rocío Rodriguez, Jorge Lantos, Ricardo Valentini, Nicolás Itcovici, Alejandra Hintze, M Laura Oyarvide, Candela Etchegaray, Alejandra Neira, Ivonne Name, Julieta Alfonso, Rocío López Castelo, Gisela Caruso, Sofía Rapelius, Fernando Alvez, Federico Etchenique, Federico Dimase, Darío Alvarez, Sofía S Aranda, Clara Sánchez Yanotti, Julián De Luca, Sofía Jares Baglivo, Sofía Laudanno, Florencia Nowogrodzki, Ramiro Larrea, María Silveyra, Gabriel Leberzstein, Alejandra Debonis, Juan Molinos, Miguel González, Eduardo Perez, Nicolás Kreplak, Susana Pastor Argüello, Luz Gibbons, Fernando Althabe, Eduardo Bergel, Fernando P Polack

New England Journal of Medicine, doi:10.1056/nejmoa2033700

which is the author's version after external peer review and before publication in the Journal, is available under a CC BY license at PMC7793608.

Appendix The authors' full names and academic degrees are as follows: Romina Libster, M.D., Gonzalo Pérez Marc, M.D., Diego Wappner, M.D., Silvina Coviello, M.S., Alejandra Bianchi, Virginia Braem, Ignacio Esteban, M.D., Mauricio T. Caballero, M.D., Cristian Wood, M.D., Mabel Berrueta, M.D., Aníbal Rondan, M.D., Gabriela Lescano, M.D., Pablo Cruz, M.D., Yvonne Ritou, M.D., Valeria Fernández Viña, M.D., Damián Álvarez Paggi, Ph.D., Sebastián Esperante, Ph.D., Adrián Ferreti, Gastón Ofman, M.D., Álvaro Ciganda, B.I.T., Rocío Rodriguez, Jorge Lantos, M.D., Ricardo Valentini, M.D., Nicolás Itcovici, M.D., Alejandra Hintze, M.D., M. Laura Oyarvide, M.D., Candela Etchegaray, M.D., Alejandra Neira, M.D., Ivonne Name, M.D., Julieta Alfonso, M.D., Rocío López Castelo, M.D., Gisela Caruso, M.D., Sofía Rapelius, M.S., Fernando Alvez, M.D., Federico Etchenique, M.D., Federico Dimase, M.D., Darío Alvarez, M.S., Sofía S. Aranda, M.D., Clara Sánchez Yanotti, Julián De Luca, Sofía Jares Baglivo, Sofía Laudanno, Florencia Nowogrodzki, Ramiro Larrea, M.

References

Agarwal, Mukherjee, Kumar, Chatterjee, Bhatnagar et al., Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial), BMJ

Arciuolo, Jablonski, Zucker, Rosen, Effectiveness of measles vaccination and immune globulin post-exposure prophylaxis in an outbreak setting -New York City, 2013, Clin Infect Dis

Avendaño-Sola, Ramos-Martinez, Munez-Rubio, Convalescent plasma for COVID-19: a multicenter, randomized clinical trial, doi:10.1101/2020.08.26.20182444v1

Cao, Wang, Wen, A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19, N Engl J Med

Chen, Nirula, Heller, SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19, doi:10.1056/NEJMoa2029849.19

Gold, Rossen, Ahmad, Race, ethnicity, and age trends in persons who died from COVID-19 -United States, May-August 2020, MMWR Morb Mortal Wkly Rep

Joyner, Senefeld, Klassen, Effect of convalescent plasma on mortality among hospitalized patients with COVID-19: initial three-month experience, doi:10.1101/2020.08.12.20169359v1

Joyner, Wright, Fairweather, Early safety indicators of COVID-19 convalescent plasma in 5000 patients, J Clin Invest

Li, Zhang, Hu, Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial, JAMA

Liu, Lin, Baine, Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study, Nat Med

Maiztegui, Fernandez, De Damilano, Efficacy of immune plasma in treatment of Argentine haemorrhagic fever and association between treatment and a late neurological syndrome, Lancet

Salazar, Christensen, Graviss, Treatment of coronavirus disease 2019 patients with convalescent plasma reveals a signal of significantly decreased mortality, Am J Pathol

Simonovich, Pratx, Scibona, A randomized trial of convalescent plasma in Covid-19 severe pneumonia, N Engl J Med

Stokes, Zambrano, Anderson, Coronavirus disease 2019 case surveillance -United States, January 22, MMWR Morb Mortal Wkly Rep

Stone, Frigault, Boyd, Efficacy of tocilizumab in patients hospitalized with Covid-19, N Engl J Med

The, Group, Effect of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med

Williamson, Walker, Bhaskaran, Factors associated with COVID-19-related death using OpenSAFELY, Nature

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