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Critiques of Trials
In this section we provide critiques of some of the published randomized trials of COVID-19 convalescent plasma. Some of these have appeared in the journals that published the trial commented on, but not all. This section will be continuously updated.
- A brief summary of the evidence for convalescent plasma efficacy by Michael Joyner and Arturo Casadevall
- Commentary by Daniele Focosi and Arturo Casadevall in Lancet Respiratory Medicine on the CONV-ERT trial
- Longer critique of CONCOR-1 TRIAL from the CCPP19 leadership group
- Critique of CONCOR-1 TRIAL (Begin et al) for NATURE-Medicine
- JAMA Editorial commenting on the WUHAN TRIAL (Li et al)
- Comment on CONTAIN COVID-19 (Ortigoza et al)
- Critique of the TSUNAMI TRIAL (Menichetti et al)
- Randomized Controlled Trial of Convalescent Plasma in COVID-19: Negative but Inconclusive
- Unpublished letter to NEJM re the SIREN-C3PO Trial (Korley et al)
- Longer critique of SIREN-C3PO (Korley et al) from the CCPP19 leadership group
- Query for the RECOVERY TRIAL (Recovery Collaborative group)
- Further Comments on the RECOVERY Trial from the CCPP19 leadership group
- Letter to the World Health Organization
- Letter to the National Insititute of Health
- Commentary on Sullivan trial and Sullivan response
Letter to the Editor: Knowlson et al.
This letter contests the claim in a paper in Health Science Reports that claimed that the Emergency Use Authorization for convalescent plasma discouraged the conduct of randomized trials. The paper has been accepted for publication in the journal.
High-titre convalescent plasma is easier than ever to procure
This paper documents the high levels of anti-spike protein antibodies to the Covid-19 virus among Italian blood donors, the result of nearly three years of COVID disease and vaccination. It is likely that the same would be found in US blood donors, indicating that it should be relatively easy to find suitably potent convalescent plasma simply by testing routinely contributed plasma units.
This paper provides an overview of the effectiveness of convalescent plasma but differs from many previous meta-analyses and systematic reviews by critically examining studies in light of key biological principles of antibody therapy. The authors (the CCPP19 leadership team led by Arturo Casadevall joined by colleagues David Sullivan and Danielle Focosi) show that studies that adhered most closely to these principles – treatment early in the disease, of patients not yet severely ill, and with specific antibody of sufficiently high dose – tended to show the effectiveness of convalescent plasma. By contrast, the several randomized trials that treated patients already oxygen or ventilator dependent, or late in the course of illness, or using plasma with insufficient antibody, generally failed to show effectiveness. The ancient medical principle that we must treat the right patient with the right dose of the right medicine at the right time is once again reaffirmed.
Ordering High Titer Convalescent Plasma for an Immunocompromised Patient With Active COVID-19
Resources for the administration and ordering of vax-plasma.
Misinterpretation of Clinical Research Findings and COVID-19 Mortality
The first 3 years of the COVID-19 pandemic witnessed an unprecedented pace of research that delivered vaccines, antiviral agents, and anti-inflammatory therapies that dramatically lessened the morbidity and mortality of COVID-19. However, some research findings led to clinical practice recommendations that were later associated with excessmortality.
Convalescent Plasma Evidence Update
Slide deck: Efficacy of high titer CCP in the treatment of COVID-19, including its utility in IC patients.