Convalescent plasma safe, effective in children with moderate-to-severe COVID-19

Treatment with COVID-19 convalescent plasma (CCP) leads to a rapid increase in antibodies and is well tolerated in paediatric patients but does not seem to interfere with immune responses measured at 21 days, results of a recent study have shown.

The authors of this single-centre prospective, open-label trial examined the safety, antibody kinetics, and outcomes of CCP (10 mL/kg, max 1 unit) treatment for COVID-19 in hospitalized paediatric patients with moderate-to-severe disease or at high risk for serious illness.

None of the 13 patients enrolled suffered infusion-related adverse events (AEs). In addition, there were no haematologic or metabolic AEs seen during hospitalization or at 3 weeks. Clinical improvements (World Health Organization eight-category ordinal severity scale for COVID-19) were noted in 10 patients by day 7.

Anti-SARS-CoV-2 antinucleocapsid immunoglobulin (Ig) G significantly increased at 24 hours after CCP administration, and high levels persisted at 7 and 21 days. Transient IgM response was observed.

Of the 13 patients, 12 (92.3 percent) were discharged home, nine (75 percent) by day 7 following CCP initiation, and one remained on invasive ventilatory support for 42 days after CCP but was eventually discharged to an intermediate care facility. A single patient died and was retrospectively confirmed to have had brain death prior to CCP.

“More paediatric data are necessary to establish the efficacy of CCP, but our data suggest benefit in moderate to severe COVID-19 when used early,” the authors said. “Other immunologic or antiviral interventions may be added as supported by emerging data.”