A study conducted in hospitalized patients by Covid-19, provided a sign that plasma blood transfusions from recovered patients improve survival rates., the largest research effort to date to shed light on the efficacy of the therapy.
The study compared 39 Covid-19 patients who received convalescent plasma transfusions with similar patients who did not receive the therapy, all at Mount Sinai Hospital in New York on the same day. period.
Researchers from the Icahn School of Medicine at Mount Sinai and the Johns Hopkins Bloomberg School of Public Health found that Convalescent patients who received plasma had better results compared to similar patients who did not receive transfusions. In the study, plasma receptors were more likely to remain stable or show an improvement in their supplemental oxygen requirements. They had also improved survival compared to control patients.
While the findings have not been subject to review or publication, they provide further evidence that plasma could be a possible interim treatment until more specific vaccines and therapies are developed. The researchers hope that plasma transfusions from patients recovered from Covid-19 can help neutralize the coronavirus in patients who are ill.
Earlier this month, a study with thousands of Covid-19 patients who received transfusions seemed to indicate that the therapy was safe. The researchers in that study said they couldn't determine if the plasma caused better results because all of the patients in the study had received it.
The Mount Sinai researchers tackled that problem by creating their own control group, made up of Covid-19 patients who did not obtain plasma but who had similar characteristics and variables, including age, sex, length of hospital stay, oxygen requirement in the day of the transfusion and whether medications such as hydroxychloroquine and the antibiotic azithromycin were administered.
The researchers were able to search for electronic health records and apply what they called a "Aggressive comparison algorithm" to find close matches with patients. Because New York City was one of the first places in the outbreak in the US. The Mount Sinai Health System offered a large group to take advantage of, with more than 4,100 confirmed Covid-19 patients admitted during the study's 16-day enrollment period.
Still, the researchers acknowledged that despite their best efforts, their conclusions are not as strong as those derived from a traditional clinical trial. The study, the largest to date to analyze plasma efficacy in Covid patients, it is still relatively small.
However, the researchers believed that creating a compatible control arm from patient records was the best opportunity to obtain immediate information while conducting more controlled trials, including those at Johns Hopkins University in Baltimore and NYU Langone Health, Montefiore Health System and Albert Einstein. New York College of Medicine.
"What matters is that people need the data now"Dr. Bouvier said. "We are trying to produce high-quality data as quickly as possible so that people in the pandemic right now can get information on whether this treatment is beneficial or harmful."
According to the study, on the day of the transfusion, most of the patients who received the plasma required supplemental oxygen and four of them needed mechanical ventilation, 14 days after the transfusion, the condition of 18% of the patients receiving the plasma would have worsened compared to 24.3% in the corresponding control group.
As of May 1, the authors wrote, 12.8% of plasma recipients would have died compared to 24.4% of control patients. "In general, we observed better survival for the plasma group"they wrote.
Another finding was that there did not appear to be a significant benefit for intubated patients; But because the number of ventilator patients in the study was small, the researchers were unable to draw definitive conclusions. Previous work on convalescent plasma has indicated that patients do better when they receive transfusions early in the course of the disease.
Dr. Bouvier said that the differences in results between the two groups of patients did not become clear until more than a week after the transfusion. Four patients in the group who received plasma remain in the hospital now, he said.
"This is a long illness", Dr. Bouvier said. "Plasma seems to have some benefits, but it is not the magic bullet. Not that you get plasma and dance a hospital staff. You are still sick".
Terry Gernsheimer, director of transfusion services for the Seattle Cancer Care Alliance, which studies plasma but was not involved in the document released Friday, said "it is not yet clear why some patients seem to benefit." She said it could be from the recovered patients' antibodies or from the transfusion itself. However, he said that the study is an early sign that the plasma may be working. "You have to take the first step," he said, "but this is only a first step."
"We still don't know what is really helping these patients," said Dr. Gernsheimer. "We still need to know what makes people better."
MORE ABOUT THESE THEMES:
First results of China's coronavirus vaccine say it is safe and generates antibodies
Coronavirus: vaccine could be in record time