Blood plasma showed no benefit in Covid-19 patients in trial — a finding that could re-energize debate

Blood plasma showed no benefit in Covid-19 patients in trial The findings, published in BMJ, could re-energize the debate over whether blood plasma is an effective treatment for the disease. Damian Garde STAT

Infusing hospitalized Covid-19 patients with blood plasma from people who recovered from the disease had no effect on whether patients got sicker or died, according to the first completed randomized trial of the treatments.

The study, published Thursday in BMJ, could re-energize the debate over whether blood plasma is an effective treatment for the disease. An earlier analysis, run by the Mayo Clinic, showed blood plasma did yield some benefit, leading the Food and Drug Administration to grant emergency access to the therapy in August. That research, however, did not have a control arm.

“My guess is that this will diminish enthusiasm for this,” said Susan Ellenberg, professor of biostatistics in and epidemiology at the Hospital of the University of Pennsylvania. “I don’t know whether it is enough to lead the FDA to withdraw its authorization for this, but it certainly suggests it’s not the lifesaver that people thought it would be.”

Other researchers said it was too soon to cast aside so-called convalescent plasma as a treatment option. In the study, which enrolled 464 adults at 39 hospitals in India, more than 80% of patients had already developed their own antibodies against Covid-19, suggesting they had contracted the virus a week or more before treatment. That’s likely too late to benefit from convalescent plasma, said Arturo Casadevall, an infectious disease expert at the Johns Hopkins Bloomberg School of Public Health, citing earlier studies in which patients appeared to improve after receiving infusions within a few days. 

“To me this is inconclusive,” Casadevall said. “We already know you need to give it early.”

Michael Joyner, a Mayo Clinic anesthesiologist who led the large convalescent plasma study cited by the FDA, agreed the trial would have reached a more meaningful conclusion had it treated patients early in their course of disease. But in the study’s defense, Joyner said, researchers knew much less about how to treat Covid-19 when the trial began in April. ...