n this open-label phase II trial from 39 hospitals in India, the researchers randomized patients to standard care (n = 229) or standard care plus convalescent plasma (n = 235). The patients had all been hospitalized with moderate illness (PaO2/FiO2 ratio between 200 mm Hg and 300 mm Hg or a respiratory rate of more than 24 per minute with oxygen saturation 93% or less on room air). To be eligible, there also had to be a matched plasma donor (adults with a previous PCR-confirmed symptomatic bout with COVID). The staff administered the convalescent plasma as two infusions administered 24 hours apart. Standard care, a kitchen sink of protocols that appeared to be unique to each hospital, could include hydroxychloroquine, oseltamivir, remdesivir, lopinavir/ritonavir, broad spectrum antibiotics, steroids, tocilizumab, and good supportive care. About two-thirds of the patients had preexisting comorbidities, and three-quarters were male. Most (91%) had dyspnea at baseline, and two-thirds had chest radiography with bilateral “patchy shadows.” After 28 days of follow-up, 41 (18%) of control patients died or had progression to severe disease compared with 44 (19%) of those receiving convalescent plasma. One potential limitation is that of the samples of convalescent plasma tested, 29% had no detectable neutralizing antibodies.
Source: Written by Henry C. Barry, MD, MS, on October 27, 2020. https://www.aafp.org/journals/afp/content/covid-briefs.html (Source: Agarwal A, Mukherjee A, Kumar G, et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial [PLACID Trial]. BMJ. 2020;371:m3939.)