geoffrey modest medical blogs

  A randomized controlled trial in India found that convalescent plasma did not help adults with moderate Covid-19 infections, the PLACID Trial (see   covid convales plasma not help bmj2020   in dropbox, or   dx.doi.org/10.1136/bmj.m3939)    Details: --464 adults admitted to one of 39 public and private hospitals across India from April till July, all with PCR=confirmed moderate Covid-19 infection (PaO 2 /FiO 2  of 200-300 mmHg or respiratory rate of > 24 per minute with oxygen saturation 93% or less on room air) -- all received the standard of care, though 235 of them also received convalescent plasma      -- those receiving convalescent plasma received 200 mL transfused 24 hours apart, for total of 2 doses      -- the presence and levels of neutralizing antibodies were not measured beforehand, but were at the end of the study -- 94% of the donors were men, mean age 34, median disease duration was 6 days, and...

A recent study found that convalescent plasma from previously infected Covid-19 survivors was basically ineffective when transfused into sick new Covid patients ( see  covid convales plasma not help rct jama2020  in dropbox, or doi:10.1001/jama.2020.10044) Details: -- 103 patients with laboratory confirmed severe Covid-19 in an open-label, multicenter, RCT in 7 medical centers in Wuhan, China. Randomized to convalescent plasma in addition to standard treatment vs standard treatment alone, stratified by disease severity -- mean age 70, more females in the transfusion group (48% vs 35%), comorbidities: hypertension 54%/cardiovasc dz 25%/diabetes 20%, body temp 36.5 deg C, resp rate 21 in transfusion group/14 control, lymphocyte 820, CRP 20 in transfusion vs 9, IL-6 17 in transfusion vs 22 control, D-dimer 2 -- convalescent plasma: they assessed the S-protein-RBD-specific (receptor binding domain) IgG antibody, which correlated strongly with the viral antibody neutralization tite...