COVID-19 Convalescent Plasma Treatment of Moderate and Severe Cases of SARS-CoV-2 Infection in Kuwait: A Multicenter Interventional Study

Background: The transfusion of COVID-19 convalescent plasma (CCP) is being considered to improve clinical outcomes in patients with COVID-19 disease. We investigated the effectiveness of CCP therapy in patients withmoderate and severe COVID-19 disease.  Methods: This non-randomized prospective cohort study was conducted from May 21, 2020, to June 30, 2020, at four major tertiary hospitals in Kuwait. CCP was administered to 135 patients. The control group comprised 233 patients who received standard treatment. All patients (N=368, median age 54 [range 15-82] years) had laboratory-confirmed SARS-CoV-2 infection and either moderate or severe COVID-19 disease. Findings: CCP treatment was significantly associated with a higher rate of clinical improvement in patients with moderate or severe disease. Among those with moderate COVID-19 disease, time to clinical improvement was 7 daysin the CCP group versus 8 days in the control group (p=0·006). For severe COVID-19 disease, time to clinical improvement was 7 days in the CCP group versus 15.5 days in the control group (p=0·003). In the adjusted analysis, the CCP-treated patients with moderate disease had significantly lower 30-day mortality. Compared to the control group, oxygen saturation improved within 3 days of CCP transfusion, and lymphocyte counts improved from day 7 in patients with moderate disease and day 11 in patients with severe disease. Furthermore, C-reactive protein declined throughout the first 14 days after CCP transfusion. None of the CCP patients developed a serious transfusion reaction. Interpretation: The data show that administration of CCP is a safe treatment option for patients with COVID-19 disease, with a favorable outcome in the rate and time to clinical improvement. Funding:  Kuwait Ministry Of Health. Trial Registration: Clinicaltrials.gov NCT04474340. Funding Statement: Kuwait Ministry Of Health Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study protocol was approved by the Ethics and Research Committee of Kuwait Ministry of Health (#2020/1417). Written informed consent was obtained from all patients or next of kin. If the patient was unconscious and next of kin not available, the healthcare proxy provided written informed consent.