The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial

Abstract. Background:. Given the controversial reports on the effect of convalescent plasma (CP) on coronavirus disease 2019 (COVID-19) patients, this study aimed to clarify the efficacy of early CP administration, improve the understanding of its impact on clinical outcomes, guide future research,...

Full description

Saved in:
Bibliographic Details
Main Authors: Saeed Mohammadi, Mandana Pouladzadeh, Hamidreza Kouhpayeh, Shamsi Okati, Mehdi Safdarian, Peyman Eshghi, Parastoo Moradi Choghakabodi, Shahabeddin Mashaei, Sharareh Sanei Sistani, Yalda Khani, Soheila Nasizadeh, Ahmad Reza Shamshiri, Amir Teimourpour, Haijuan Wang
Format: Article
Language:English
Published: Wolters Kluwer Health - Lippincott Williams Wilkins 2025-01-01
Series:​​​​​​​​Infectious Diseases & Immunity
Online Access:http://journals.lww.com/10.1097/ID9.0000000000000145
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841538955136204800
author Saeed Mohammadi
Mandana Pouladzadeh
Hamidreza Kouhpayeh
Shamsi Okati
Mehdi Safdarian
Peyman Eshghi
Parastoo Moradi Choghakabodi
Shahabeddin Mashaei
Sharareh Sanei Sistani
Yalda Khani
Soheila Nasizadeh
Ahmad Reza Shamshiri
Amir Teimourpour
Haijuan Wang
author_facet Saeed Mohammadi
Mandana Pouladzadeh
Hamidreza Kouhpayeh
Shamsi Okati
Mehdi Safdarian
Peyman Eshghi
Parastoo Moradi Choghakabodi
Shahabeddin Mashaei
Sharareh Sanei Sistani
Yalda Khani
Soheila Nasizadeh
Ahmad Reza Shamshiri
Amir Teimourpour
Haijuan Wang
author_sort Saeed Mohammadi
collection DOAJ
description Abstract. Background:. Given the controversial reports on the effect of convalescent plasma (CP) on coronavirus disease 2019 (COVID-19) patients, this study aimed to clarify the efficacy of early CP administration, improve the understanding of its impact on clinical outcomes, guide future research, address safety concerns, and inform public health policies. Methods:. In this prospective, multicenter, randomized controlled trial conducted at Razi Hospital (Ahvaz) and Bouali Hospital (Zahedan) in Iran, 232 confirmed COVID-19 patients were randomly assigned into two groups using a computer-generated randomization method. The treatment group (n = 116) received CP with anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) IgG titer ≥1/160 on the first day of admission, along with routine antiviral medications, while the control group received only routine medications (n = 116). Recruitment occurred from 1 March to 30 July 2020, with two months of post-intervention follow-up. The primary outcome was two-month mortality, and secondary outcomes included CP-related side effects and various clinical and laboratory parameters. Results:. No significant differences were observed between the groups in terms of age (P = 0.119), sex (P = 0.418), comorbidities (P > 0.05), or pre- and post-treatment changes in temperature, lymphocyte count, erythrocyte sedimentation rate, or platelet count (all P > 0.05). Despite a higher CT severity score at admission in the treatment group (P < 0.001), improvements in respiratory rate, C-reactive protein, and lactate dehydrogenase occurred earlier and were more pronounced compared to the control group (P < 0.05). No side effects related to CP therapy were observed during infusion or follow-up. However, no significant differences were observed between the groups in the mortality rate or length of hospitalization. The mortality rate in the treatment group was 11.2% (13/116), compared to 17.2% (20/116) in the control group (P = 0.130). The median hospital stay was 7 days (95% CI: 6–8 days) for the treatment group and 6 days (95% CI: 5–7 days) for the control group (P = 0.560). Conclusion:. While administering CP with a high titer of anti-SARS-CoV-2 IgG early in infection may improve vital signs and laboratory parameters in COVID-19 patients, it does not significantly reduce mortality risk or length of hospitalization compared to routine medications. Overall, the treatment appears to have few side effects, suggesting it may be a safe option for further evaluation in managing early COVID-19 symptoms. Trial registration:. This prospective, multicenter, two-parallel randomized controlled trial was prospectively registered in the Iranian Clinical Trials Registry (IRCT20200310046736N1).
format Article
id doaj-art-2ebade599ada491887cefa2e0144e087
institution Kabale University
issn 2096-9511
2693-8839
language English
publishDate 2025-01-01
publisher Wolters Kluwer Health - Lippincott Williams Wilkins
record_format Article
series ​​​​​​​​Infectious Diseases & Immunity
spelling doaj-art-2ebade599ada491887cefa2e0144e0872025-01-14T07:30:25ZengWolters Kluwer Health - Lippincott Williams Wilkins​​​​​​​​Infectious Diseases & Immunity2096-95112693-88392025-01-0151283510.1097/ID9.0000000000000145202501000-00003The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trialSaeed Mohammadi0Mandana Pouladzadeh1Hamidreza Kouhpayeh2Shamsi Okati3Mehdi Safdarian4Peyman Eshghi5Parastoo Moradi Choghakabodi6Shahabeddin Mashaei7Sharareh Sanei Sistani8Yalda Khani9Soheila Nasizadeh10Ahmad Reza Shamshiri11Amir Teimourpour12Haijuan Wang1 Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran 14166-34793, Iran4 Emergency Medicine Department, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 61357-15794, Iran5 Tropical and Infectious Diseases Department, Zahedan University of Medical, Zahedan 98167-43463, Iran3 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran 14166-51157, Iran6 Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 61357-15794, Iran3 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran 14166-51157, Iran8 School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 61357-15794, Iran5 Tropical and Infectious Diseases Department, Zahedan University of Medical, Zahedan 98167-43463, Iran5 Tropical and Infectious Diseases Department, Zahedan University of Medical, Zahedan 98167-43463, Iran5 Tropical and Infectious Diseases Department, Zahedan University of Medical, Zahedan 98167-43463, Iran3 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran 14166-51157, Iran9 Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran 14166-34793, Iran3 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran 14166-51157, IranAbstract. Background:. Given the controversial reports on the effect of convalescent plasma (CP) on coronavirus disease 2019 (COVID-19) patients, this study aimed to clarify the efficacy of early CP administration, improve the understanding of its impact on clinical outcomes, guide future research, address safety concerns, and inform public health policies. Methods:. In this prospective, multicenter, randomized controlled trial conducted at Razi Hospital (Ahvaz) and Bouali Hospital (Zahedan) in Iran, 232 confirmed COVID-19 patients were randomly assigned into two groups using a computer-generated randomization method. The treatment group (n = 116) received CP with anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) IgG titer ≥1/160 on the first day of admission, along with routine antiviral medications, while the control group received only routine medications (n = 116). Recruitment occurred from 1 March to 30 July 2020, with two months of post-intervention follow-up. The primary outcome was two-month mortality, and secondary outcomes included CP-related side effects and various clinical and laboratory parameters. Results:. No significant differences were observed between the groups in terms of age (P = 0.119), sex (P = 0.418), comorbidities (P > 0.05), or pre- and post-treatment changes in temperature, lymphocyte count, erythrocyte sedimentation rate, or platelet count (all P > 0.05). Despite a higher CT severity score at admission in the treatment group (P < 0.001), improvements in respiratory rate, C-reactive protein, and lactate dehydrogenase occurred earlier and were more pronounced compared to the control group (P < 0.05). No side effects related to CP therapy were observed during infusion or follow-up. However, no significant differences were observed between the groups in the mortality rate or length of hospitalization. The mortality rate in the treatment group was 11.2% (13/116), compared to 17.2% (20/116) in the control group (P = 0.130). The median hospital stay was 7 days (95% CI: 6–8 days) for the treatment group and 6 days (95% CI: 5–7 days) for the control group (P = 0.560). Conclusion:. While administering CP with a high titer of anti-SARS-CoV-2 IgG early in infection may improve vital signs and laboratory parameters in COVID-19 patients, it does not significantly reduce mortality risk or length of hospitalization compared to routine medications. Overall, the treatment appears to have few side effects, suggesting it may be a safe option for further evaluation in managing early COVID-19 symptoms. Trial registration:. This prospective, multicenter, two-parallel randomized controlled trial was prospectively registered in the Iranian Clinical Trials Registry (IRCT20200310046736N1).http://journals.lww.com/10.1097/ID9.0000000000000145
spellingShingle Saeed Mohammadi
Mandana Pouladzadeh
Hamidreza Kouhpayeh
Shamsi Okati
Mehdi Safdarian
Peyman Eshghi
Parastoo Moradi Choghakabodi
Shahabeddin Mashaei
Sharareh Sanei Sistani
Yalda Khani
Soheila Nasizadeh
Ahmad Reza Shamshiri
Amir Teimourpour
Haijuan Wang
The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
​​​​​​​​Infectious Diseases & Immunity
title The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
title_full The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
title_fullStr The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
title_full_unstemmed The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
title_short The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
title_sort effectiveness of convalescent plasma administered on the first day of admission for covid 19 patients an open label randomized controlled trial
url http://journals.lww.com/10.1097/ID9.0000000000000145
work_keys_str_mv AT saeedmohammadi theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT mandanapouladzadeh theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT hamidrezakouhpayeh theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shamsiokati theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT mehdisafdarian theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT peymaneshghi theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT parastoomoradichoghakabodi theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shahabeddinmashaei theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shararehsaneisistani theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT yaldakhani theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT soheilanasizadeh theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT ahmadrezashamshiri theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT amirteimourpour theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT haijuanwang theeffectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT saeedmohammadi effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT mandanapouladzadeh effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT hamidrezakouhpayeh effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shamsiokati effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT mehdisafdarian effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT peymaneshghi effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT parastoomoradichoghakabodi effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shahabeddinmashaei effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT shararehsaneisistani effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT yaldakhani effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT soheilanasizadeh effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT ahmadrezashamshiri effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT amirteimourpour effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial
AT haijuanwang effectivenessofconvalescentplasmaadministeredonthefirstdayofadmissionforcovid19patientsanopenlabelrandomizedcontrolledtrial