Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

eLife

Jonathon W Senefeld¹  Michael J Joyner¹  Stephen A Klassen¹  R Scott Wright²  Nigel Paneth³  Arturo Casadevall⁴  Quigly Dragotakes⁴  Patrick W Johnson⁵  Rickey E Carter⁵ 

[1] Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, United States;Department of Cardiology, Mayo Clinic, Rochester, United States;Department of Epidemiology and Biostatistics and Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, United States;Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, United States;Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, United States;

关键词: COVID;    virus infection;    convalescent plasma;    Human;   

DOI  :  10.7554/eLife.69866

来源: eLife Sciences Publications, Ltd

【 摘 要 】

Background:The US Food and Drug Administration authorized COVID-19 convalescent plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the USA.Methods:We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.Results:CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = −0.52, p=0.002) between CCP usage per hospital admission and deaths occurring 2 weeks after admission, and this finding was robust to examination of deaths taking place 1, 2, or 3 weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.Conclusions:A strong inverse correlation between CCP use and mortality per admission in the USA provides population-level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.Funding:There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.

【 授权许可】

CC BY