Last September, the results of a Spanish study led by the Puerta de Hierro University Hospitalwhich predicted that treatment with blood plasma donated by people recovered from covid-19 may be beneficial in patients who are in early stages of the disease.

This research, based on a clinical trial with 350 patients from 27 Spanish hospitals, also indicated that this treatment may be suitable for immunosuppressed people.

Precisely, these are also some of the main conclusions of a new study led by the New York University Grossman School of Medicine (NYU, USA), which included data from the Spanish study and seven others carried out in the United States, Belgium, Brazil, India and the Netherlands. The study was published today in the journal open JAMA network.

The new work, based on data from eight studies, shows that among 2,341 patients, those who were injected with convalescent plasma soon after admission were 15% less likely to die.

With this information, the authors showed that among the 2,341 patients, those who received convalescent plasma injection soon after admission had 15% less chance of dying within a month for covid-19, compared to those who did not receive the treatment or those who received an inactive saline placebo.

The team also found that the greatest benefits of the therapy occurred among patients most at risk of serious complications due to pre-existing conditions, such as diabetes waves heart disease. It also appears to benefit those with blood type A or AB, according to the study.

Treatment with convalescent plasma is still considered experimental by the US Food and Drug Administration (FDA). This fluid contains antibodies, blood proteins that are part of the immune system. According to the researchers, the antibodies bind to the virus, SARS-CoV-2, and mark it for elimination from the body.

This fluid contains antibodies that adhere to the SARS-CoV-2 virus and tag it to eliminate it from the body.

“Our results show that, in general, hospitalized patients with COVID-19 may derive modest benefits from convalescent plasma, with some subgroups of patients benefiting more than others,” he says. Andrea Troxelexpert in biostatistics and principal investigator of the study.

With regard to the groups most likely to benefit, the FDA reviewed on December 28, 2021 the authorization for the emergency use of convalescent plasma, limiting its use to patients with diseases that suppress their immune system, or who receive medical treatments with the same effect.

Troxel adds that “Patients with coexisting diseases were the ones who evolved the most with convalescent plasma, probably because they are the ones who have the most difficulty in producing antibodies to fight their infection. The introduced plasma increases your body’s ability to fight the virus, but only in the early stages of the disease and before the infection invades your body.”

The key: identifying the right patients

For your part, Cristina Avendaño-Solaan expert in clinical pharmacology at Hospital Universitario Puerta de Hierro and one of the lead authors of the Spanish study used by NYU, told SINC: “Identifying which types of patients benefit most from passive immunotherapy [tratamiento con plasma] It is a crucial issue that is still unresolved, even with this publication.”

Considers that it is necessary to continue working and comparing data to give an reliable answer. “At the moment,” he adds, “the factors that best predict an effect that may be relevant are the early use of plasma after infection and its use in immunosuppressed patients at risk for poor outcomes.”

Avendaño-Sola highlights that the results of the new work are consistent with their study. “The main contribution of this work is in the union of patient results from different trials in a joint analysis, which provides greater certainty about the results”, he emphasizes.

Convalescent plasma is an accessible and low-cost resource with the advantage that, if the donation is local, it is more likely that the variant against which the donor produced antibodies is the same that causes the disease in the recipient.

Cristina Avendaño-Sola (Puerta de Hierro University Hospital)

As for the suitability of this treatment, which so far has shown modest results, the researcher emphasizes that this “depends on the existence of better alternatives available. We saw that several of monoclonal antibodies initially developed are not useful against the omicron variant and there is still limited availability of other synthetic antivirals.”

Modest effectiveness, but relevant in specific cases

He also emphasizes that “convalescent plasma is a low-cost, accessible resource with the advantage that, if the donation is local, it is more likely that the variant against which the donor has produced antibodies is the same that causes the disease. on the receiver.”

“In patients with limited ability to develop their own immune response, the modest efficacy of plasma may be relevant if we don’t have better tools and if the administration is early”, adds the expert.

Furthermore, Avendaño-Solá highlights that another aspect highlighted by the NYU study is the “magnificent collaboration and information sharing among researchers that this pandemic has escalated to levels we would not have imagined before.”

Reference:

Andrea Troxel and others. “Effect of COVID-19 convalescent plasma on clinical status in hospitalized patients: a meta-analysis of real-time individual patient data from randomized controlled trials.” open JAMA network

Rights: Creative Commons.

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