⚠️PLASMA TRANSFUSION: Whoa - plasma from recovered #COVID19 patients tested in 10 severe cases showed that 1 dose (200 mL) of CP could increase or maintain the neutralizing antibodies at a high level, symptoms improved in 3 days, w/ viral load gone in 7 d. pnas.org/content/early/…
2) “No severe adverse effects were observed. These results indicate that CP can serve as a promising rescue option for severe COVID-19, while the randomized trial is warranted.” #COVID19
3) Prior to CP treatment, 3 patients had mechanical ventilation, 3 had high-flow nasal cannula oxygenation. All symptoms in the 10 patients, especially fever, cough, shortness of breath, and chest pain, disappeared or largely improved within 1-3 days upon CP transfusion. #COVID19
4) After CP treatment, 2 patients were weaned from mechanical ventilation to high-flow nasal cannula, and one patient discontinued high-flow nasal cannula. in one patient treated with conventional nasal oxygenation, continuous oxygenation was shifted to intermittent oxygenation.
5) on chest CTs, all patients showed different degrees of absorption of pulmonary lesions after CP transfusion. Ie. lesions disappeared.
6) “Of note is that SARS-CoV-2 RNA was decreased to an undetectable level in three patients on day 2, three patients on day 3, and one patient on day 6 after CP therapy. These results are in support of a neutralizing effect of CP on serum SARS-CoV-2.” #COVID19
7) CONTROLS: non-randomized convenience controls: “historic control group was formed by random selection of 10 patients from the cohort treated in the same hospitals and matched by age, gender, and severity of the diseases to the 10 cases in our trial.”...
8) “Baseline characteristics of patients between groups showed no sig differences, while clinical outcomes different: 3 cases discharged & 7 in much improved & ready for discharge in CP, as compared to 3 deaths, 6 stabilized, and 1 improved in controls (P<0.001 for diff) #COVID19 
9) So I do have a bone to pick w/ the authors- this is not a “trial” as they claim. They had historical conveniently sampled controls to compare to, but historic controls were not pre determined & not asked to pre enroll in study. Retrospective and observational controls at best.
10) In general though, this is an interesting study with somewhat compelling preliminary evidence it can work. Just wished the editors of @PNASNews (top journal of @theNASciences) were a little more careful with editing in the study design. “Trial” is a loaded word these days.
11) Also, 1 dose of just 200 ml is tiny amount of plasma. According to FDA rules, person can typically donate 690-880 ml plasma, and up to 2 donations/week (48 hrs apart). Thus, one recovered person could maybe donate 5-6 doses a week. But lots of tests needed. Can’t do this yet.
