Clinical trial concludes convalescent plasma “futile” as COVID-19 treatment

A new clinical trial concluded convalescent plasma is “futile” as a novel coronavirus (COVID-19) treatment for most critically ill patients, according to results published in JAMA.

 In the earliest days of the COVID-19 pandemic, the medical community turned to a century-old treatment: take blood from recovered patients and give it to the sick. The hypothesis was that components in the so-called “convalescent plasma” that fought off the disease once could do it again, something that has worked in other diseases, such as Ebola.

The findings are the latest from REMAP-CAP (Randomised, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia), which has enrolled thousands of patients in hundreds of hospitals around the world to quickly determine what COVID-19 treatments work best in which patients. To date, more than 400 UPMC patients have been enrolled.

In the convalescent plasma trial, REMAP-CAP enrolled about 2,000 adults hospitalized with severe COVID-19. They were randomized to either receive two units of convalescent plasma or no plasma and followed to see if the likelihood of surviving at least three weeks without needing organ support, such as a ventilator, differed based on whether they were treated or not.

The trial concluded for futility when enough data was collected to say with greater than 99 percent certainty that convalescent plasma did not help critically ill COVID-19 patients. However, the results followed a slightly different pattern for the 126 patients who were immunocompromised. This group appeared to do slightly better with the convalescent plasma treatment compared to the standard treatment, but the number of patients was too small to make a definitive statement.

The researchers could not determine why convalescent plasma did not improve outcomes in most critically ill patients.

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