Serial Convalescent Plasma Infusions for the Initial COVID-19 Infections in the Appalachian Region of West Virginia

Author:

Peppers Brian P.1ORCID,Shmookler Aaron2ORCID,Stanley Johnathan3,Giblin Sutton Lisa4,Perrotta Peter L.2,Kieffer Theodore2,Skoner David1,Mahady Stacey5,Lewandrowski Callum5,Damron Heath67,Horspool Alexander67,Sakhuja Ankit8,McCarthy Paul8,Hostoffer Robert W.9

Affiliation:

1. WVU Medicine Children’s Hospital, Section of Allergy and Immunology, Morgantown, WV, USA

2. Department of Pathology, Anatomy and Laboratory Sciences, West Virginia University School of Medicine, Morgantown, WV, USA

3. West Virginia University Medicine United Hospital Center, Bridgeport, WV, USA

4. WVU Medicine, In-Patient Pharmacy, Investigational Drug Services, Morgantown, WV, USA

5. WVU Medicine, Pediatric and Internal Medicine Residency Program, Morgantown, WV, USA

6. Vaccine Development Center at West Virginia University, Morgantown, WV, USA

7. Department of Microbiology, Immunology, and Cell Biology West Virginia University, Morgantown, WV, USA

8. WVU Medicine Division of Cardiovascular Critical Care, Dept of Cardiovascular and Thoracic Surgery, Morgantown, WV, USA

9. Allergy-Immunology Fellowship, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

Abstract

Purpose The rapid spread of SARS-CoV-2, the virus that is responsible for causing COVID-19, has presented the medical community with another example of when convalescent plasma (CP) is still used today. The ability to standardize CP at the onset of a pandemic is unlikely to exist in a reliable and uniformly reproducible way. We hypothesized that CP of unknown strength given in a serial manner will promote health and reduce mortality in those inflicted with COVID-19. Methods Participants were given up to 8 CP-units depending on their condition upon entry into the study and their response. Results 102 out of 117 participants were given CP. The earlier a participant received CP corelated with survival (p = 0.0004). The number of CP-units given, throughout all the clinical severities, was not significant with outcomes, p = 0.3947. A higher number of CP-units given to the severe/critical participants (without biological immunosuppressants or restrictive lung disease) did correlate with survival p = 0.0116 (2.8 vs. 2 units). Lower platelets on admission corelated with mortality. Platelet levels increase correlated with CP infusions p < 0.0001. Conclusion This study supports the serial use of CP of unknown strength based on clinical response for those infected with COVID-19. The use of 3–4 units of CP was found to be statistically significant for survival for severe and critical participants without restrictive lung disease and chronic biological immunosuppression. Increased platelet levels after CP infusions supports that CP is promoting overall health regardless of outcomes.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Immunology and Allergy

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