Plasma with neutralizing antibody titer of at least 1:160 reduces mortality at 28 days versus standard care
By Elana Gotkine HealthDay Reporter
MONDAY, Oct. 30, 2023 (HealthDay News) — For patients with COVID-19-induced acute respiratory distress syndrome (ARDS), administration of plasma from convalescent donors with a neutralizing antibody titer of at least 1:160 within five days after initiation of invasive mechanical ventilation reduces mortality at 28 days, according to a study published online Oct. 26 in the New England Journal of Medicine. The study was published to coincide with the annual congress of the European Society of Intensive Care Medicine, held from Oct. 21 to 25 in Milan.
Benoît Misset, M.D., from the University Hospital of Liège in Belgium, and colleagues randomly assigned adults with COVID-19-induced ARDS who had been receiving invasive mechanical ventilation for less than five days to receive convalescent plasma with a neutralizing antibody titer of at least 1:320 or standard care alone (237 and 238 patients, respectively). Due to a shortage of convalescent plasma, 17.7 percent of patients in the convalescent-plasma group received a neutralizing antibody titer of 1:160.
Glucocorticoids were administered to 98.1 percent of the patients. The researchers found that mortality was 35.4 and 45.0 percent in the convalescent-plasma and standard-care groups, respectively, at day 28. This effect was mainly seen in patients who underwent randomization 48 hours or less after initiation of invasive mechanical ventilation in a prespecified analysis. There was no substantial difference noted between the groups in serious adverse events.
“We believe our trial has a good potential for generalizability to most patients with COVID-19-induced ARDS because almost 50 percent of such patients were included in the centers during their participation in the trial,” the authors write.
Several authors disclosed ties to industry.
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