Clinical Efficacy of Early Administration of Convalescent Plasma among COVID-19 Cases in Egypt

Background: The rapid worldwide spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 pandemic from its epicentre; Wuhan has led to an epidemiological breakdown. Egypt reported its first COVID-19 case on Feb 14, 20202,3. Thereafter, Egypt scaled-up preventive measures, with a partial lockdown starting on March 25. Several therapeutic agents along with Convalescent Plasma Transfusion are under investigation and data from Convalescent Plasma Transfusions (CPT) have been receiving a lot of attention, after Emergency approvals from the Food and Drug Administration (FDA) suggesting that it may provide a clinical effect in the treatment of SARS-COV-2 Importance: Early and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infection Methods: -Designs: An interventional, single-arm, non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020. -Settings: This was a multi-centre study conducted in 3 hospitals in Egypt. -Participants: a total of 94 COVID-19 laboratory-confirmed patients using qRT-PCR were enrolled in the study. -Intervention: All patients were administered with two plasma units (each unit is 200cc). The volume of donated plasma was 800cc. -Main Outcome and Measures: Primary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within seven days Results: A total of 94 patients were enrolled who received CPT either within seven days or after seven days of hospitalization. 82 were severely ill, 12 were critically ill. The average age remained 58 years (±SD 15.1 years). Male were 69% and 49% patients got cured while 51% died with CFR 51%. 75% deaths were above 45years of age. The symptoms were dyspnoea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained Diabetes Mellitus (21%) and Asthma (14%). Among 40-60 years Hypertension (56%), Diabetes Mellitus (39%) and among >60 years age group Hypertension (57%) and Chronic Heart Disease (24%) were reported. CPT within seven days remained significant as compared with the CPT after seven days with the number of days to cure (p=0.007) and ICU stay (P=0.008) among severely ill cured cases. Conclusions: Among patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within seven days with 65% cure rate. Trial Registration: Clinical Intervention identifier: MOHP_COVID-19_Ver1.1 registered April 2020 Keywords: Covid 19 pandemic, Convalescent plasma, SARS-CoV-2,