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Cited by 873

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults

Open access
Libster, Romina, Pérez Marc, Gonzalo, Wappner, Diego, Coviello, Silvina, Bianchi, Alejandra, Braem, Virginia, Esteban, Ignacio, Caballero, Mauricio T., Wood, Cristian, Berrueta, Mabel, Rondan, Aníbal, Lescano, Gabriela, Cruz, Pablo, Ritou, Yvonne, Fernández Viña, Valeria, Álvarez Paggi, Damián, Esperante, Sebastián, Ferreti, Adrián, Ofman, Gastón, Ciganda, Álvaro, Rodriguez, Rocío, Lantos, Jorge, Valentini, Ricardo, Itcovici, Nicolás, Hintze, Alejandra, Oyarvide, M. Laura, Etchegaray, Candela, Neira, Alejandra, Name, Ivonne, Alfonso, Julieta, López Castelo, Rocío, Caruso, Gisela, Rapelius, Sofía, Alvez, Fernando, Etchenique, Federico, Dimase, Federico, Alvarez, Darío, Aranda, Sofía S., Sánchez Yanotti, Clara, De Luca, Julián, Jares Baglivo, Sofía, Laudanno, Sofía, Nowogrodzki, Florencia, Larrea, Ramiro, Silveyra, María, Leberzstein, Gabriel, Debonis, Alejandra, Molinos, Juan, González, Miguel, Perez, Eduardo, Kreplak, Nicolás, Pastor Argüello, Susana, Gibbons, Luz, Althabe, Fernando, Bergel, Eduardo, Polack, Fernando P.·2021·New England Journal of Medicine
DOI 10.1056/nejmoa2033700
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Abstract

Abstract Background Therapies to interrupt progression of early COVID-19 remain elusive. Among them, convalescent plasma in hospitalized patients was unsuccessful, perhaps because antibody should be administered earlier. We advanced plasma infusions to the first 72 hours of symptoms to arrest COVID-19 progression. Methods A randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV2 in elderly subjects within 72 hours of mild COVID-19 symptoms. The primary endpoint was severe respiratory disease defined as a respiratory rate ≥30 and/or an O 2 sat<93% in room air. The study was interrupted at 76% of its projected sample size, because cases in the region decreased considerably and steady enrollment of study subjects became virtually impossible. Results 160 patients underwent randomization. In the intention-to-treat analysis (ITT), 13/80(16.2%) patients receiving plasma vs. 25/80(31.2%) receiving placebo experienced severe respiratory disease [RR(95%CI)= 0.52(0.29,0.94); p=0.026)] with an RRR=48%. A modified ITT analysis, excluding six subjects who experienced the primary endpoint before infusion, showed a larger effect size [RR(95%CI) = 0.40(0.20, 0.81), p=0.007]. High- and low-titer donor analyses, based on a median IgG titer=1:3,200, evidenced a dose-dependent response with an RRR=73.3% for recipients of high-titer plasma (p=0.016) and a number needed to treat (NNT)=4.4. All secondary endpoints exhibited trends towards protection. No solicited adverse events were observed. Conclusions Early administration of high-titer convalescent plasma against SARS-CoV2 to mildly ill infected seniors reduced COVID-19 progression. This safe, inexpensive, outpatient intervention facilitates access to treatment from industrialized to LMIC, can decompress demands on hospitals, and may contribute to save lives. Funded by The Bill & Melinda Gates Foundation and The Fundación INFANT Pandemic Fund. Registered in the Dirección de Sangre y Medicina Transfusional del Ministerio de Salud (PAEPCC19), Plataforma PRIISA (1421), and clinicaltrials . gov ( NCT04479163 ) . All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; RL, GPM, DW and FPP are investigators in a phase 3 SARS CoV2 trial from Pfizer; no other relationships or activities that could appear to have influenced the submitted work.

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Metadata

Authors
Libster, R., Pérez Marc, G., Wappner, D., Coviello, S., Bianchi, A., Braem, V., Esteban, I., Caballero, M. T., Wood, C., Berrueta, M., Rondan, A., Lescano, G., Cruz, P., Ritou, Y., Fernández Viña, V., Álvarez Paggi, D., Esperante, S., Ferreti, A., Ofman, G., Ciganda, Á., Rodriguez, R., Lantos, J., Valentini, R., Itcovici, N., Hintze, A., Oyarvide, M. L., Etchegaray, C., Neira, A., Name, I., Alfonso, J., López Castelo, R., Caruso, G., Rapelius, S., Alvez, F., Etchenique, F., Dimase, F., Alvarez, D., Aranda, S. S., Sánchez Yanotti, C., De Luca, J., Jares Baglivo, S., Laudanno, S., Nowogrodzki, F., Larrea, R., Silveyra, M., Leberzstein, G., Debonis, A., Molinos, J., González, M., Perez, E., Kreplak, N., Pastor Argüello, S., Gibbons, L., Althabe, F., Bergel, E., & Polack, F. P.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2021-02-18
Volume
384
Issue
7
Pages
610-618
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa2033700
OpenAlex
W3119294059
Cited by
873
References
18
FWCI
61.89
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. https://app.cochat.ai/papers/10.1056/nejmoa2033700
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Libster, R., Pérez Marc, G., Wappner, D., Coviello, S., Bianchi, A., Braem, V., Esteban, I., Caballero, M. T., Wood, C., Berrueta, M., Rondan, A., Lescano, G., Cruz, P., Ritou, Y., Fernández Viña, V., Álvarez Paggi, D., Esperante, S., Ferreti, A., Ofman, G., . . . Polack, F. P. (2021). Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2033700

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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