Addition of convalescent plasma to systemic corticosteroids in early phase of COVID-19

Abstract

Introduction: By the mid-February of 2021, systemic corticosteroids are the only evident therapeutic agent against COVID-19 with respiratory failure. Convalescent plasma has been largely used for COVID-19, but the evidence regarding its’ efficacy is unclear.

Aim: To evaluate the efficacy of addition of convalescent plasma to systemic corticosteroids in early phase of severe COVID-19 pneumonia.

Methods: 158 hospitalized patients with severe and life-threatening COVID-19 pneumonia retrospectively evaluated. The patients whom administered convalescent plasma and/or systemic corticosteroids in 10 days after symptom onset were included. Exclusion criterion were negative swab for SARS-CoV-2, late onset of these treatment agents.

Results: 89 eligible patients were classified into two groups: systemic corticosteroids alone group (n:70) and convalescent plasma plus corticosteroids group (n:19). In-hospital mortality was lower in convalescent plasma plus corticosteroids group compared to the other group group (15,8% vs 24,3% respectively), but not statistically significant (p=0.54). Similarly, ICU need was lower in convalescent plasma plus corticosteroids group (21,1% vs 28,6%) but not statistically significant either (p=0.576). Viral clearance was significantly faster in corticosteroids alone group (mean±SD 8,8±4,1 days vs 13,6±7,5 days, p=0.004).

Conclusions: Although, addition of convalescent plasma to systemic corticosteroids did not statistically improve in-hospital mortality, there was a trend towards to be lower in mortality rate and ICU need. Considering the difference of sample sizes between the groups, if number of patients in the groups increase this trend could be statistically significant.