Virginia Research Day 2021

DOES COVID -19 CONVALESCENT PLASMA IMPROVE COVID 19 HOSPITALIZED PATIENTS’ OUTCOMES? Elizabeth Ullrich, DO, Andrew Wyker, DO, Andrew Doyle, DO, Ryan O'Connell, DO, Michael Moore, MD Sovah Internal Medicine Residency Program, Danville, VA

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Introduction: The Mayo Clinic developed a clinical trial in early 2020 of convalescent plasma (CCP) from patients recovered from SARS-CoV-2 to treat patients hospitalized with Covid-19. In May 2020, they expanded access nationwide to the trial. This was a non-randomized prospective observational study. Sovah Health-Danville saw a marked increase in hospitalized patients with severe Covid-19 in the spring of 2020. Given the rise in cases in our community, lack of any proven effective therapies at the time, and the low risk of CCP, our hospital decided to participate in this expanded access clinical trial from May of 2020 until August 28, 2020 when the trial ended. The objective of our study was to compare length of stay, mortality, need for ICU level of care and days of ventilator support in patients hospitalized at SOVAH Health Danville who received CCP versus those who did not. Methods: A retrospective study of 90 patients, 18 years of age or older hospitalized with severe Covid-19 comparing outcomes of those who received CCP and those who did not. Anyone hospitalized with Covid- 19 was eligible to receive plasma at discretion of primary hospitalist and if the specific Mayo Clinic IRB Informed Consent could be obtained. Data collected from the health systems’ electronic health record system included age, gender, total length of stay, ICU length of stay, number of ventilator days, time from diagnosis of Covid-19 to transfusion of plasma, and final outcomes (death versus discharge). Study patients or their legal representative provided informed consent under the supervision of the Mayo Clinic IRB. For participation in the trial. Results: 45 patients received CCP with 28.8% mortality, 63.6% deaths male and 36.3% female, 60% required ICU level care, 53.3% required ventilator, mean age 61.2 years, total length of stay 15.82 days, mean ICU length of stay 14.3 days, mean ventilator days 12.75, and a mean time to transfusion of plasma from diagnosis 5.2 days. For 45 patients who did not receive plasma, the mortality rate was 11.11%, 26.7% required ICU level care, 17.8% required ventilator, mean age was 71.2 years, mean total length of stay was 10.51 days, mean ICU length of stay 8 days, mean ventilator days 8.6 .

66%

45 patients in Each Group

28.8%

17.8%

15.82

12.75

11.1%

10.51

8.6

Conclusion: This study demonstrated that in these two groups of patients with Covid-19, the outcomes (mortality, length of stay) for Covid-19 patients who received CCP were not improved when compared to those who did not. It is of note that more patients who received CCP required ICU level of care compared to those receiving CCP indicating that they had more severe infections which could have effected the outcomes. In addition, our study did not compare the presence of co-morbid conditions such as diabetes mellitus, body weight, etc., between the 2 groups which are known to increases Covid 19 mortality. Finally, our data also did not address whether giving CCP earlier in the course of a Covid 19 infection (< 5 days after diagnosis) would have produced different results. This study demonstrated no benefit in providing CCP to hospitalized patient with Covid-19.

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