• Ralph Rogers, Fadi Shehadeh, Evangelia K Mylona, Josiah Rich, Marguerite Neill, Francine Touzard-Romo, Sara Geffert, Jerome Larkin, Jeffrey A Bailey, Shaolei Lu, Joseph Sweeney, and Eleftherios Mylonakis.
• Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, RI, USA.
• Clin. Infect. Dis. 2020 Oct 10.

BackgroundThe efficacy of convalescent plasma (CP) for the treatment of COVID-19 remains unclear.MethodsIn a matched cohort analysis of hospitalized patients with severe COVID-19, the impact of CP treatment on in-hospital mortality was evaluated using univariate and multivariate Cox proportional-hazards models, and the impact of CP treatment on time to hospital discharge was assessed using a stratified log-rank analysis.Results64 patients who received CP a median of 7 days after symptom onset were compared to a matched control group of 177 patients. The incidence of in-hospital mortality was 12.5% and 15.8% in the CP and control groups, respectively (p = 0.52). There was no significant difference in the risk of in-hospital mortality between the two groups (adjusted hazard ratio [aHR] 0.93, 95% confidence interval [CI] 0.39 - 2.20). The overall rate of hospital discharge was not significantly different between the two groups (rate ratio [RR] 1.28, 95% CI 0.91 - 1.81), although there was a significantly increased rate of hospital discharge among patients 65-years-old or greater who received CP (RR 1.86, 95% CI 1.03 - 3.36). There was a greater than expected frequency of transfusion reactions in the CP group (2.8% reaction rate observed per unit transfused).ConclusionsWe did not demonstrate a significant difference in risk of mortality or rate of hospital discharge between the CP and control groups. There was a signal for improved outcomes among the elderly, and further adequately powered randomized studies should target this subgroup when assessing the efficacy of CP treatment.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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