The COVID-19 blood plasma assay found no benefit in critically ill patients

LONDON (Reuters) – An international trial testing convalescent blood plasma in COVID-19 patients with moderate and severe illness stopped enrolling critically ill COVID-19 patients who needed intensive care after finding no benefit, the researchers said Monday. market.

The decision of the leaders of the REMAP-CAP study came after an initial analysis of more than 900 seriously ill study participants in intensive care showed that treatment with the product – an antibody-rich plasma taken from people who recovered from the pandemic disease – not improve the results.

“There was no evidence of damage associated with the administration of convalescent plasma” (e) the study continues to recruit hospitalized COVID-19 patients who are moderately ill but not in intensive care, said the scientists who lead the study in a statement.

“It is biologically plausible that patients who are not producing antibodies at the time of convalescent plasma therapy and patients with an excess of virus can benefit more than others. Our additional analyzes will explore this, ”said Manu Shankar-Hari, a clinician and professor of intensive medicine at British hospital Guy’s and St. Thomas, who co-leads the study.

He added that the initial analysis did not assess the effects of plasma in hospitalized patients with less severe disease. This “remains a very important issue” and would continue to be explored in the ongoing trial, he said.

The underlying hypothesis for using convalescent plasma as a potential treatment for COVID-19 patients is that the antibodies it contains can neutralize the virus, preventing it from replicating and stopping tissue damage.

But this initial analysis leading to the REMAP-CAP pause in recruiting critically ill patients showed that there was a very low probability – 2.2% – that it reduced mortality rates or decreased the number of days that patients needed intensive care.

“Why convalescent plasma does not seem to improve the outcome in critically ill patients with COVID-19 admitted to the ICU is not yet known. However, it may be because lung damage is too advanced for convalescent plasma to make a difference, ”said Alexis Turgeon, an intensive physician and professor at Université Laval in Canada, who is also working on the trial.

REMAP-CAP is an international clinical trial that explores potential treatments for COVID-19. It has already recruited 4,100 patients with COVID-19 at more than 290 clinical centers in Europe, the Americas, Asia, Africa and Australasia.

Separate findings from REMAP-CAP showed last week that treating severely ill COVID-19 patients with Roche’s Actemra or Sanofi’s Kevzara for arthritis has significantly improved survival rates and reduced the time patients need intensive care.

The study is also looking at the potential effects of a number of other existing therapies, including anticoagulant drugs, antiplatelet agents, antibiotics, statins and vitamin C.