Coronavirus disease 2019 (COVID-19) convalescent plasma was found to lower hospital stay and oxygen requisition in COVID-19 hospitalized patients including those having hematological malignancies.

A study was carried out to examine the effect of COVID-19 convalescent plasma in 16 patients critically ill with coronavirus.

Convalescent plasma donors donated two to four units each (200 ml/unit), 18 to 56 days after complete recovery from coronavirus. Notably, 16 subjects (10 males, 6 females,  were administered convalescent plasma after informed consent. In the study cohort, six participants had hematological malignancies.

Overall, five participants were cured after procuring individual emergency Investigational New Drug (eIND) from the Food and Drug Administration (FDA), while the leftover 11 participants were recruited in the researcher-initiated clinical trial (Expanded Access to Convalescent Plasma to Treat and Prevent Pulmonary Complications Associated With COVID-19).

Enzyme-linked immunosorbent assay (ELISA) was utilized to assess the Spike protein immunoglobulin G (IgG) titers on most convalescent plasma units. Therapy was with a single unit of 200 ml of convalescent plasma administered over one hour, with the exception of participants 4 and 9 who were given 2 units eight days apart.

No noxious events were witnessed in the participants. Only, one patient (patient-10) developed fever due to convalescent plasma infusion that led to termination after administering 50% of the volume. Following each convalescent plasma infusion, constant improvement in oxygenation levels was noted. 

All of the five intubated subjects were extubated between 1- and 19-days post convalescent plasma infusion. The remaining 11 subjects demonstrated a considerable decrease in oxygen requirements and did not need ventilatory support. Of the 16 subjects incorporated, only 1 participant died after extubation secondary to the advancement of medical co-morbidities. Among the 15 subjects surviving, patient-12 remained inpatient for respiratory failure after extubation to tracheostomy, while the rest were discharged including the 6 subjects having hematological malignancy.

Although all the participants displayed improvement following convalescent plasma, a vital correlation was witnessed between clinical improvement and early convalescent plasma infusion (r=0.6, p=0.02, for correlation between time from disease onset to convalescent plasma, and time from convalescent plasma to oxygen independence or discharge). However, data interpretation could be affected by the concomitant trial recruitment of some patients. 

While a randomized controlled clinical trial stays the gold standard, the limited data indicate a signal that convalescent plasma appears to be safe and efficacious and underscores a promising role for passive immunity in coronavirus infection.