Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19

Source : JAMA. Published online June 3, 2020. doi:10.1001/jama.2020.10044

Auteur : Ling Li; Wei Zhang; Yu Hu; et al

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ANALYSE

Commentateur

Dr REY David

Objectif

Evaluer l’efficacité et la tolérance de transfusion de plasma de personnes convalescentes (guérison depuis au moins 2 semaines, PCR négativée 2 fois, 18-55 ans, vérification sérologie COVID).

Points forts

Etude randomisée comparative.

Points faibles

Fin d’étude prématurée (fin d’épidémie), donc effectif inférieur aux 200 patients prévus. Autres traitements possibles (antiviraux, corticoïdes), sans “contrôle” entre les 2 groupes.

Conclusion

Globalement pas de bénéfice clinique de la transfusion de plasma; petit bénéfice pour les formes sévères sans engagement du pronostic vital. Négativation des PCR plus rapides après transfusion de plasma.

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IMPORTANT

Convalescent plasma is a potential therapeutic option for patients with coronavirus disease 2019 (COVID-19), but further data from randomized clinical trials are needed.

OBJECTIVE

To evaluate the efficacy and adverse effects of convalescent plasma therapy for patients with COVID-19.

CONCLUSION AND RELEVANCE

Among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to clinical improvement within 28 days. Interpretation is limited by early termination of the trial, which may have been underpowered to detect a clinically important difference.