Study with UPMC researchers, patients finds convalescent plasma 'futile' in treating most critically ill covid patients

Early in the covid-19 pandemic calls were put out for anyone who had survived the virus to donate plasma if they were able to do so, as so-called “survivor plasma” had been used successfully to treat other viruses.

The National Institutes of Health halted its own convalescent plasma trials for emergency room patients with mild symptoms in late winter, citing “no significant benefit.” Similar results came from trials in those early on in their illness.

Now, an international research team including UPMC scientists and patients claims to have put to rest the idea that the plasma can be helpful for the most critically ill patients, calling it “futile” as a covid-19 treatment. Results of the research are published in the Journal of the American Medical Association, concurrent with a presentation at the European Society of Intensive Care Medicine’s annual meeting.

“There were biologically plausible reasons to turn to convalescent plasma early in the pandemic when hundreds of thousands of people were getting sick and treatments had yet to be discovered,” said Dr. Bryan McVerry, a UPMC intensivist who was co-lead author of the study.

“Unfortunately, it was either being administered outside of clinical trials or in trials that weren’t focused on critically ill patients, slowing our ability to see if it actually worked,” McVerry said.

The therapy dates to the 1800s and early 1900s when it was used to help treat viruses like the measles and Spanish flu. More recently, it showed some success in treating Ebola.

The latest trial reached its conclusion when researchers had gathered enough data to say “with greater than 99% certainty that convalescent plasma did not help critically ill covid-19 patients,” Pitt officials said in a statement.

Results were different for 126 patients enrolled in the study who were considered immunocompromised, researchers said. That group did somewhat better with the plasma treatment, Pitt said.

“It could be that patients with an impaired immune system, who are unable to mount an effective immune response, could still benefit from the antibodies present in blood plasma from covid-recovered patients, especially early on in the illness,” said Dr. Lisa Estcourt, a professor of hematology and transfusion medicine at Oxford University.

Dr. Derek Angus, chief innovation officer at UPMC, said the overall ineffectiveness of the plasma treatment could be based on too few high-quality antibodies in the plasma coupled with an illness too far along for antibodies to help.

He said it isn’t efficient to continue using convalescent plasma treatment when monoclonal antibodies are shown to be effective.