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,...
Saved in:
Main Authors: | , , , , , , , , , , , , , |
---|---|
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 WilkinsInfectious 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 |