Several days ago I posted about the FDA approval to start clinical trials to see how convalescent plasma of patients who had already beat COVID-19 would hopefully help patients who are currently suffering from COVID-19. This was now published in JAMA.
This paper on plasma in COVID was published in JAMA yesterday states that there was an “improvement in clinical status” in the population it was provided for. Sweet, but let’s start off with a reality check before we get enthusiastic.
This is a report on only five patients. Five. Cinco. We clear? Good. This is also NOT a randomized clinical trial. It’s case series. You know, like if I were to publish the Vitamin C data from my shop, no one will believe it bc it’s full of my bias. Same thing applies here.
Important takeaways about Convalescent Plasma per the JAMA article:
These patients did not improve overnight which should provide us with some preparation as to when we could see our own FDA approved trials result.
Generally speaking, it took 7 to 12 days to start seeing some benefits on the vent.
These patients were all on the vent for more than 10 days which is what we are seeing here in the US and also quite terrifying. They had all been hospitalized for 10-20 days before this was provided.
The length of stay for all five of these patients was greater than 50 days when all was said and done.
The largest concern is that there was only one patient with a SOFA score greater than 10. That patient actually got worse before he got better and was actually on ECMO.
I really wish they had done some matching with non-plasma receiving patients to learn how these patients behave at baseline.
The viral load was also difficult to predict the efficacy of plasma on. Seems as if there was, at least in my opinion, a large variety of when they cleared the virus.
Multiple interventions: all of these patients were on steroids, 4/5 were on the lopinavir/ritonavir combo which was shown to not have benefit in an NEJM study, and other meds. Obviously they were throwing the kitchen sink at these patients.
Given that it’s just five patients, its really hard to know whether the plasma worked, whether it was one of the other meds, or whether they got better on their own. It’s too soon to say whether this works or not.
We’re in deep poop, team. The largest value of this study is to just see how these five patients behaved overall. The worst is yet to come. Rest up and be prepared.
Click here for breakdowns of other COVID-19 Articles.
Shen C, Wang Z, Zhao F, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783
Link to Abstract
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