Effectiveness of Convalescent Plasma Therapy in Critically Ill COVID-19 Patients: Early Experience from a Dedicated ICU of Bangladesh

Abstract

Introduction: The management of severe or critical COVID-19 patients in the ICU includes supportivecare as well as repurposed drugs and revival of old strategies like human convalescent plasma therapy(CPT) in the absence of specific therapy against SARS-CoV-2 virus. CPT appears to be an attractivetreatment option as passive antibody transfer, but efficacy remains controversial. Objectives: To determine the effectiveness of convalescent plasma therapy in management of criticallyillCOVID-19 patients admitted at the dedicated intensive care unit of Kurmitola General Hospital, Dhaka. Study Method: All patients admitted in the ICU of Kurmitola General Hospital, Dhaka from 1st May to30th September 2020 were included in this retrospective observational cohort study. The protocolwasapproved by the Ethical and Scientific Committee of the hospital. The clinical and treatment data ofall participants were collected; and the association of CPT and mortality benefit was observed betweenthe patients who received plasma therapy during ICU stay and who didn’t. The statistical analysis wasperformed using the Windows based statistical software package SPSS version 25. Results: A total of 228 critically illCOVID-19 patients were admitted to the ICU of Kurmitola GeneralHospital in the specified time period. Among them, 160 (70%) were male and 68 (30%) females. Mean agewas 57.97 (95% CI 56.23-59.70) years. Important co-morbidities were obstructive airway diseases 160(70.17%), hypertension 117 (51.31%) and diabetes mellitus 103 (45.17%). Only 53 (23.25%) patients receivedCPT during ICU stay. The median day of receiving CPT from the day of symptom onset was 12 (IQR 10-14) days in the survivor group and 18 (IQR 16-19) days in the non-survivor group (p<0.0001). All-causeICU mortality was 29 (54.7%) in CPT group vs. 115 (65.7%) in Non-CPT group (p=0.146). The odds ratioof survival in CPT group was 0.757 (95% CI 0.528-1.085). Conclusion: This retrospective cross-sectional study suggested that the efficacy of use of convalescentplasma in critical or severe COVID-19 patients admitted to ICU is conflicting for mortality benefit. JBSA 2021; 34(1): 26-31