In a study published in The New England Journal of Medicine, clinicians and researchers from the CHU of Liège and the University of Liège show that the administration of plasma taken from convalescent donors after infection with Sars-CoV-2 to patients suffering from acute respiratory distress syndrome requiring artificial mechanical ventilation significantly reduced mortality (10%).
T
he randomised trial involved 17 intensive care units in Belgian hospitals. It included a total of 475 patients during the different waves of Covid-19, from October 2020 to March 2022. A group of 237 patients received convalescent plasma, with the remaining 238 patients receiving standard care.
The reduction in mortality observed on day 28 was around 10% in the group of patients who received convalescent plasma up to five days after the administration of invasive mechanical ventilation (i.e. using endo-tracheal intubation). In this group, 35% of patients died, compared with 45% in the group of patients who received standard care. The effect on reducing mortality was more specifically observed in patients who received convalescent plasma during the first 48 hours after being put on artificial respiratory assistance.
Thanks to the collaboration of the Belgian Red Cross and the laboratories of the KULeuven, UAntwerpen and ULiège, the intensive care units of the study's partner hospitals were able to use convalescent plasma with high neutralising antibody titres of 1/320 for 82.3% of patients and 1/160 for the remaining 17.7%.
Various medical trials were carried out around the world using convalescent plasma during the Covid-19 pandemic, but this study is the first to specifically target the effects on the patients most at risk, those in acute respiratory distress requiring artificial respiratory assistance. "For the first time, we have demonstrated the therapeutic value of convalescent plasma in improving the very poor vital prognosis of these patients. The reduction in mortality, of the order of 10%, is particularly noticeable in patients who were given convalescent plasma rapidly after the start of artificial respiratory ventilation", explains Dr Benoît Misset, head of the intensive care unit at the CHU of Liège and Assistant Professor at the Faculty of Medicine at the University of Liège, who is responsible for and first author of the study.
"This study documents and confirms the value of convalescent plasma for passive immunisation against the most severe forms of Covid-19, but also against possible future more pathogenic variants and possibly in the event of future pandemics".
Scientific reference
“Convalescent Plasma for Covid-19–Induced ARDS in Mechanically Ventilated Patients”, New England Journal of Medicine, NEJM, October 26, 2023, DOI: 10.1056/NEJMoa2209502
Authors : Benoît Misset, MD (1), Michael Piagnerelli, MD, PhD (2), Eric Hoste, MD, PhD (3), Nadia Dardenne, MSc (4), David Grimaldi, MD, PhD (5), Isabelle Michaux, MD, PhD (6), Elisabeth De Waele, MD, PhD (7), Alexander Dumoulin, MD (8), Philippe G Jorens, MD, PhD (9), Emmanuel van der Hauwaert, MD (10), Frédéric Vallot, MD (11), Stoffel Lamote, MD (12), Walter Swinnen, MD (13), Nicolas De Schryver, MD (14), Vincent Fraipont, MD (15), Nathalie de Mey, MD (16), Nicolas Dauby, MD, PhD (17), Nathalie Layios, MD (1), Jean-Baptiste Mesland, MD, PhD (18), Geert Meyfroidt, MD, PhD (19), Michel Moutschen, MD, PhD (20), Veerle Compernolle, MD, PhD (21), André Gothot, MD, PhD (22), Daniel Desmecht, DVM, PhD (23), Maria Isabel Taveira da Silva Pereira, MD, PhD (24) Mutien Garigliany, DVM, PhD (23), Tome Najdovski, PhD (25), Axelle Bertrand, MSc (1), Anne-Françoise Donneau, PhD (4), Pierre-François Laterre, MD (18)
- Department of Intensive Care Medicine, University Hospital, Liege, Belgium
- Department of Intensive Care Medicine, CHU-Charleroi Marie-Curie Hospital, Université Libre de Bruxelles, Charleroi, Belgium
- Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, Gent, Belgium
- Biostatistic Unit, Public Health Department, Liège University, Liege, Belgium
- Department of Intensive Care Medicine, Cliniques Universitaires de Bruxelles - Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Department of Intensive Care, Université Catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
- Department of Intensive Care Medicine, Vrije Universiteit Brussel Brussels University Hospital, Jette, Belgium
- Department of Intensive Care Medicine, Delta General Hospital, Roeselare, Belgium
- Department of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
- Department of Intensive Care Medicine, Imelda General Hospital, Bonheiden, Belgium
- Department of Intensive Care Medicine, Wallonie Picarde General Hospital, Tournai, Belgium
- Department of Intensive Care Medicine, Groeninge General Hospital, Kortrijk, Belgium
- Department of Intensive Care Medicine, Sint Blasius General Hospital, Dendermonde, Belgium
- Department of Intensive Care Medicine, Saint-Pierre Medical Clinic, Ottignies, Belgium
- Department of Intensive Care Medicine, Citadelle General Hospital, Liege, Belgium
- Department of Intensive Care Medicine, OLV General Hospital, Aalst, Belgium
- Division of Infectious Diseases, Saint Pierre University Hospital, Brussels, Belgium
- Department of Intensive Care Medicine, Saint-Luc University Hospital, Brussels, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Belgium
- Department of Infectious diseases, Liege University Hospital, Belgium
- Blood Services from the Red Cross, Mechelen, Belgium, and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Immunohematology, Liege University Hospital, Liege, Belgium
- Department of Animal Pathology, Liège University, Liege, Belgium
- Department of Microbiology, Liege University Hospital, Liege, Belgium
- Blood Services from the Red Cross, Suarlée, Belgium
Study funded by the Belgian Healthcare Knowledge Centre (KCE): https://kce.fgov.be/en/kce-trials/funded-trials/confident-a-multicentre-randomized-trial-to-assess-the-efficacy-of-convalescent-plasma-therapy-in
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Dr Pr Benoît Misset
Donner aux individus les moyens de vivre une vie saine et promouvoir le bien-être à tous les âges Le troisième objectif vise à assurer la santé et le bien-être de tous, en améliorant la santé procréative, maternelle et infantile, en réduisant les principales maladies transmissibles, non transmissibles, environnementales et mentales.
