Pathogen reduction with methylene blue does not have an impact on the clinical effectiveness of COVID‐19 convalescent plasma

Abstract

AbstractBackground and ObjectivesThere is a concern about a possible deleterious effect of pathogen reduction (PR) with methylene blue (MB) on the function of immunoglobulins of COVID‐19 convalescent plasma (CCP). We have evaluated whether MB‐treated CCP is associated with a poorer clinical response compared to other inactivation systems at the ConPlas‐19 clinical trial.Materials and MethodsThis was an ad hoc sub‐study of the ConPlas‐19 clinical trial comparing the proportion of patients transfused with MB‐treated CCP who had a worsening of respiration versus those treated with amotosalen (AM) or riboflavin (RB).ResultsOne‐hundred and seventy‐five inpatients with SARS‐CoV‐2 pneumonia were transfused with a single CCP unit. The inactivation system of the CCP units transfused was MB in 90 patients (51.4%), RB in 60 (34.3%) and AM in 25 (14.3%). Five out of 90 patients (5.6%) transfused with MB‐treated CCP had worsening respiration compared to 9 out of 85 patients (10.6%) treated with alternative PR methods (p = 0.220). Of note, MB showed a trend towards a lower rate of respiratory progressions at 28 days (risk ratio, 0.52; 95% confidence interval, 0.18–1.50).ConclusionOur data suggest that MB‐treated CCP does not provide a worse clinical outcome compared to the other PR methods for the treatment of COVID‐19.