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Blood Plasma Therapy Does Not Help Critically Ill COVID-19 Patients: Study

Convalescent plasma does not reduce the risk of intubation or death in COVID-19 patients, according to a study which found that people receiving the therapy experienced more serious adverse events than those receiving standard care.

Intubation is a procedure where a tube is inserted into the windpipe to facilitate breathing. The research, published in the journal Nature Medicine, also found that the antibody profile in the blood of people who have had the virus is extremely variable and this can alter the response to treatment.

Convalescent plasma therapy uses the blood of people who have recovered from illness to help others recover. “It was thought that blood plasma from COVID-19 survivors would help those seriously ill with the virus but, unfortunately, this is not the case,” said study co-principal investigator Donald Arnold, professor. at McMaster University in Canada. . “We caution against using convalescent plasma to treat hospitalized COVID-19 patients, unless they are participating in a closely monitored clinical trial,” Arnold said.

The research team also found that patients receiving recovery plasma had significantly more serious adverse events than those receiving standard care. The majority of those events were an increased need for oxygen and worsening respiratory failure, they said. However, the rate of fatal incidents was not significantly different from the control group of patients who had not received blood.

The clinical trial, called CONCOR-1, included 940 patients at 72 hospitals in Canada, the United States and Brazil. The test revealed that the convalescent plasma had a highly variable donor antibody content due to the highly variable immune response to the virus.

It has been observed that different antibody profiles in convalescent plasma have a significant impact on whether or not patients experience intubation or death. Unfavorable antibody profiles, i.e., low antibody titers, non-functional antibodies, or both, were associated with a higher risk of intubation or death.

“These results may explain the seemingly conflicting results between randomized trials showing no benefit and observational studies showing better results with higher titer products compared to low titer products,” said the co-principal investigator. of the study, Jeannie Callum, associate scientist at the Sunnybrook Research Institute. in Canada. “It appears that it is not the high titer convalescent plasma that is useful, but rather the low titer convalescent plasma is harmful,” Callum said.

The researchers noted that the harm can come from transfusion of convalescent plasma containing malfunctioning antibodies. “One hypothesis is that these dysfunctional antibodies could compete with the patient’s own antibodies and could disrupt the growing immune response,” said study co-principal investigator Philippe Begin, associate professor at the University of Montreal in Canada. “This phenomenon has already been observed in animal models and in human studies of HIV vaccines,” Begin said.

He added that the CONCOR-1 researchers expect to collaborate with other researchers in the international study to understand the potential risks and benefits of convalescent plasma. “This information from Canada’s largest clinical trial on convalescent plasma and COVID-19 can be analyzed with the results of several similar studies underway around the world to provide more solid information and insights that will guide clinical practice.” and global health policies, ”he added. added.

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