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Transfusing Convalescent Plasma as Post-Exposure Prophylaxis Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Double-Blinded, Phase 2 Randomized, Controlled Trial.


ABSTRACT:

Background

The efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) convalescent plasma (CCP) for preventing infection in exposed, uninfected individuals is unknown. CCP might prevent infection when administered before symptoms or laboratory evidence of infection.

Methods

This double-blinded, phase 2 randomized, controlled trial (RCT) compared the efficacy and safety of prophylactic high titer (≥1:320 by Euroimmun ELISA) CCP with standard plasma. Asymptomatic participants aged ≥18 years with close contact exposure to a person with confirmed coronavirus disease 2019 (COVID-19) in the previous 120 hours and negative SARS-CoV-2 test within 24 hours before transfusion were eligible. The primary outcome was new SARS-CoV-2 infection.

Results

In total, 180 participants were enrolled; 87 were assigned to CCP and 93 to control plasma, and 170 transfused at 19 sites across the United States from June 2020 to March 2021. Two were excluded for screening SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) positivity. Of the remaining 168 participants, 12/81 (14.8%) CCP and 13/87 (14.9%) control recipients developed SARS-CoV-2 infection; 6 (7.4%) CCP and 7 (8%) control recipients developed COVID-19 (infection with symptoms). There were no COVID-19-related hospitalizations in CCP and 2 in control recipients. Efficacy by restricted mean infection free time (RMIFT) by 28 days for all SARS-CoV-2 infections (25.3 vs 25.2 days; P = .49) and COVID-19 (26.3 vs 25.9 days; P = .35) was similar for both groups.

Conclusions

Administration of high-titer CCP as post-exposure prophylaxis, although appearing safe, did not prevent SARS-CoV-2 infection.

Clinical trials registration

NCT04323800.

SUBMITTER: Shoham S 

PROVIDER: S-EPMC9129191 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Transfusing Convalescent Plasma as Post-Exposure Prophylaxis Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Double-Blinded, Phase 2 Randomized, Controlled Trial.

Shoham Shmuel S   Bloch Evan M EM   Casadevall Arturo A   Hanley Daniel D   Lau Bryan B   Gebo Kelly K   Cachay Edward E   Kassaye Seble G SG   Paxton James H JH   Gerber Jonathan J   Levine Adam C AC   Naeim Arash A   Currier Judith J   Patel Bela B   Allen Elizabeth S ES   Anjan Shweta S   Appel Lawrence L   Baksh Sheriza S   Blair Paul W PW   Bowen Anthony A   Broderick Patrick P   Caputo Christopher A CA   Cluzet Valerie V   Cordisco Marie Elena ME   Cruser Daniel D   Ehrhardt Stephan S   Forthal Donald D   Fukuta Yuriko Y   Gawad Amy L AL   Gniadek Thomas T   Hammel Jean J   Huaman Moises A MA   Jabs Douglas A DA   Jedlicka Anne A   Karlen Nicky N   Klein Sabra S   Laeyendecker Oliver O   Lane Karen K   McBee Nichol N   Meisenberg Barry B   Merlo Christian C   Mosnaim Giselle G   Park Han-Sol HS   Pekosz Andrew A   Petrini Joann J   Rausch William W   Shade David M DM   Shapiro Janna R JR   Singleton J Robinson JR   Sutcliffe Catherine C   Thomas David L DL   Yarava Anusha A   Zand Martin M   Zenilman Jonathan M JM   Tobian Aaron A R AAR   Sullivan David J DJ  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20230201 3


<h4>Background</h4>The efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) convalescent plasma (CCP) for preventing infection in exposed, uninfected individuals is unknown. CCP might prevent infection when administered before symptoms or laboratory evidence of infection.<h4>Methods</h4>This double-blinded, phase 2 randomized, controlled trial (RCT) compared the efficacy and safety of prophylactic high titer (≥1:320 by Euroimmun ELISA) CCP with standard plasma. Asymptomatic p  ...[more]

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