Results of the CAPSID randomized trial for high-dose convalescent plasma in patients with severe COVID-19
Sixten Körper, Manfred Weiss, Daniel Zickler, Thomas Wiesmann, Kai Zacharowski, Victor M Corman, Beate Grüner, Lucas Ernst, Peter Spieth, Philipp M Lepper, Martin Bentz, Sebastian Zinn, Gregor Paul, Johannes Kalbhenn, Matthias M Dollinger, Peter Rosenberger, Thomas Kirschning, Thomas Thiele, Thomas Appl, Benjamin Mayer, Michael Schmidt, Christian Drosten, Hinnerk Wulf, Jan Matthias Kruse, Bettina Jungwirth, Erhard Seifried, Hubert Schrezenmeier, CAPSID Clinical Trial Group, Sixten Körper, Manfred Weiss, Daniel Zickler, Thomas Wiesmann, Kai Zacharowski, Victor M Corman, Beate Grüner, Lucas Ernst, Peter Spieth, Philipp M Lepper, Martin Bentz, Sebastian Zinn, Gregor Paul, Johannes Kalbhenn, Matthias M Dollinger, Peter Rosenberger, Thomas Kirschning, Thomas Thiele, Thomas Appl, Benjamin Mayer, Michael Schmidt, Christian Drosten, Hinnerk Wulf, Jan Matthias Kruse, Bettina Jungwirth, Erhard Seifried, Hubert Schrezenmeier, CAPSID Clinical Trial Group
Abstract
BACKGROUNDCOVID-19 convalescent plasma (CCP) has been considered a treatment option for COVID-19. This trial assessed the efficacy of a neutralizing antibody containing high-dose CCP in hospitalized adults with COVID-19 requiring respiratory support or intensive care treatment.METHODSPatients (n = 105) were randomized 1:1 to either receive standard treatment and 3 units of CCP or standard treatment alone. Control group patients with progress on day 14 could cross over to the CCP group. The primary outcome was a dichotomous composite outcome of survival and no longer fulfilling criteria for severe COVID-19 on day 21.ResultsThe primary outcome occurred in 43.4% of patients in the CCP group and 32.7% in the control group (P = 0.32). The median time to clinical improvement was 26 days in the CCP group and 66 days in the control group (P = 0.27). The median time to discharge from the hospital was 31 days in the CCP group and 51 days in the control group (P = 0.24). In the subgroup that received a higher cumulative amount of neutralizing antibodies, the primary outcome occurred in 56.0% of the patients (vs. 32.1%), with significantly shorter intervals to clinical improvement (20 vs. 66 days, P < 0.05) and to hospital discharge (21 vs. 51 days, P = 0.03) and better survival (day-60 probability of survival 91.6% vs. 68.1%, P = 0.02) in comparison with the control group.ConclusionCCP added to standard treatment was not associated with a significant improvement in the primary and secondary outcomes. A predefined subgroup analysis showed a significant benefit of CCP among patients who received a larger amount of neutralizing antibodies.Trial registrationClinicalTrials.gov NCT04433910.FundingBundesministerium für Gesundheit (German Federal Ministry of Health): ZMVI1-2520COR802.
Keywords: COVID-19; Clinical Trials; Immunoglobulins.
Conflict of interest statement
Conflict of interest: Victor M. Corman is named together with Euroimmun on a patent application filed recently regarding the diagnosis of SARS-CoV-2 by antibody testing (“Methods and reagents for diagnosis of SARS-CoV-2 infection.” Patent application no. EP3809137A1).
Figures
![Figure 1. Patient enrollment and treatment assignment.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8516466/bin/jci-131-152264-g001.jpg)
![Figure 2. Occurrence of secondary outcomes.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8516466/bin/jci-131-152264-g002.jpg)
![Figure 3. Clinical outcomes according to ordinal…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8516466/bin/jci-131-152264-g003.jpg)
![Figure 4. Occurrence of secondary outcomes by…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8516466/bin/jci-131-152264-g004.jpg)
Source: PubMed