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New study examines the benefits of convalescent plasma for some patients with COVID-19

New study examines the benefits of convalescent plasma for some patients with COVID-19

 


TPlasma transfusions provided by people who have recovered from COVID-19 may help patients hospitalized with the virus, new international studies show.

This treatment, known as convalescent plasma, is still considered by the US Food and Drug Administration (FDA). Plasma contains antibodies and blood proteins that are part of the immune system. According to researchers, COVID-19, SARS-CoV-2, and antibodies are shaped to aggregate and attach to the virus that causes them to tag for removal from the body.

In this study, led by researchers at the NYU Grossman School of Medicine, of the 2,341 men and women who received convalescent plasma immediately after admission, they received COVID-19 within a month than those who did not. It has been shown that the chances of dying are 15% lower. Patients receiving convalescent plasma or inert saline placebo.

In particular, researchers have found that the greatest benefit of treatment lies in patients who are at greatest risk of serious complications due to pre-existing conditions such as: Diabetes Or heart disease. Treatments that include the antibodies and other immune cells needed to fight the infection also appear to benefit people with type A or AB blood.

“Our results, overall, may allow patients admitted with COVID-19 to benefit moderately from convalescent plasma, with some patient subgroups benefiting more than others. It shows that there is a possibility, “says Principal Investigator and Biostatistician. Andrea B. Troxel, ScD.. For the groups most likely to benefit, the FDA revised the Emergency Use Authorization for Convalescent Plasma on December 28, 2021 to patients with diseases that suppress the immune system, or to receive treatment with the same effect. Limited use to patients.

“Patients with comorbidity were most likely to show improvement from convalescent plasma, perhaps because it was most difficult to produce antibodies to fight the infection,” Dr. Troxel added. “Infused plasma enhances their body’s ability to fight the virus, but only in the early stages of the disease, before the disease overwhelms their body.”

Current findings, Published in the journal JAMA network open January 25th onlineIs from a pool of patient information from eight recently completed studies in the United States, Belgium, Brazil, India, the Netherlands and Spain on the effects of COVID-19’s restorative plasma.

These benefits of treatment are likely to become more apparent as more data from the trial becomes available, Dr. Troxel said. Population Health Bureau At NYU Langone. This is because the data from individual trials are too small to show the overall impact of treatment on a subset of patients, she says. Several individual studies have shown that treatment is ineffective or of limited value.

Collaborator research Dr. Eva PetkovaThe team uses research data to create a patient descriptor scoring system for age, stage of COVID-19, co-morbidities, etc., making it easy for clinicians to benefit most from the use of convalescent plasma. It states that it is possible to calculate.

“Our Therapeutic Effect Index is designed to serve as a rapid and effective tool for physicians to use when deciding when to administer COVID-19 convalescent plasma,” said the population. Dr. Petkova, a professor of the Faculty of Health, said. Child and adolescent psychiatry At NYU Langone. The Treatment Efficacy Index is available online for free.

In this study, researchers conducted small-scale, individualized clinical trials of convalescent plasma therapy, including trials at NYU Langone, Albert Einstein College of Medicine, Montefiore Medical Center, Zuckerberg San Francisco General Hospital, and the University of Pennsylvania in Philadelphia. Grouped all patient information from the study. Researchers wanted the benefits and disadvantages of treatment to be easier to find in as many samples as possible of the patient. All trials were randomized and controlled. That is, patients could be randomly assigned to receive or not receive convalescent plasma.

The analysis included data from another multicenter US study Issued separately in December 2021 JAMA Internal Medicine.. In the study of 941 patients admitted with COVID-19, those who received high-dose convalescent plasma therapy and who were not taking other drugs such as remdesivir or corticosteroids were treated with plasma. It has been shown that it is likely to benefit from.Research by Co-Principal Investigator Mira B. Ortigosa, MD, PhD, Associate Professor medicine When Microbiology In NYU Langone, these early results support the idea that convalescent plasma may be a viable treatment option, especially when other treatments are not yet available, such as at the beginning of a pandemic. I say I did.

In addition, convalescent plasma collected from previously infected and subsequently vaccinated donors (vax-plasma) has sufficient amounts and diversity of antibodies to provide additional protection against new viral variants. Included, says Dr. Ortigoza. Viruses usually mutate genetically during a pandemic (getting random changes in DNA or RNA coding). For this reason, convalescent plasma tends to be less effective over time, as compared to treatment types that need to undergo a redesign process to address new variants such as monoclonal antibody therapy. It may provide effective treatment more quickly after mutation.

In addition to Dr. Troxel, Dr. Petkova, and Dr. Ortigoza, other NYU Langone researchers involved in the study Keith S. Goldfeld, DrPh; Mengling Liu, PhD; Dr. Hyun G. Park; Dr. Sadeus TarpeyYinxiang Wu, MA; Danni Wu, MS; Yi Li, MS; Corita R. Grudzen, MD; When Judith S. Hockman, MD.. Other investigators are Anup Agarwal, MD, Gunjan Kumar, MD, and Aparna Mukherjee, MD, PhD of the Indian Medical Research Council in New Delhi. Dr. Christina Avendanhosora, Ph.D. in Rafael Duarte, Dr. Arancha Sancholopes, Ph.D. in Puerta Hospital, Majadahonda University, Madrid, Spain. Emma Bainbridge, MD, MPH, Priscilla Hsue, MD, and Annie Luetkemeyer, MD; University of California, San Francisco. Dr. Catherine Barr and Dr. Pamela Shaw of the University of Pennsylvania (now Kaiser Permanente) in Philadelphia. Timothy Devos, MD, PhD, and Geert Meyfroidt, MD, PhD from Katholieke Universiteit in Leuven, Belgium. Andre Nikola, Ph.D., University of Brasília, Brazil. Liise-Anne Pirofski, MD, PhD, and Hyun-Ah Yoon, MD at Albert Einstein College of Medicine in New York City; Bart Rijnders, MD, PhD, and Casper Rokx, MD, PhD at Erasmus University in the Netherlands. Elliott Ant-Man, Ph.D. in Medicine, Harvard University, Boston. Research funding was provided by the National Institutes of Health grant UL1TR001445.

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