What is the role of convalescent plasma in the treatment of coronavirus disease 2019 (COVID-19)?

Updated: Jun 25, 2021
  • Author: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The FDA granted emergency use authorization (EUA) on August 23, 2020 for use of convalescent plasma in hospitalized patients with COVID-19. Convalescent plasma contains antibody-rich plasma products collected from eligible donors who have recovered from COVID-19. An expanded access (EA) program for convalescent plasma was initiated in early April 2020. [128, 195]  The Mayo Clinic coordinated the open-access COVID-19 expanded access program, but discontinued enrollment on August 28, as the FDA authorized emergency use. For further information regarding administration, see the EUA COVID-19 Convalescent Fact Sheet for Health Care Providers.

NIH guidelines 

The NIH COVID-19 Guidelines Panel further evaluated the Mayo Clinic’s EAP data and further reviewed subgroups. Among patients who were not intubated, 11% of those who received convalescent plasma with high antibody titers died within 7 days of transfusion compared with 14% of those who received convalescent plasma with low antibody titers. Among those who were intubated, there was no difference in 7-day survival. [196]   

The NIH halted its trial of convalescent plasma in emergency departments for treatment of patients with mild symptoms as of March 2021. The second planned interim analysis of the trial data determined that while the convalescent plasma intervention caused no harm, it was unlikely to benefit this group of patients. 

IDSA guidelines 

IDSA recommends limiting use of high-titer convalescent plasma for hospitalized patients with COVID-19 to the context of a clinical trial. Convalescent plasma transfusion failed to show or to exclude a beneficial or detrimental effect on mortality based on the body of evidence. [25]  


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