Multi‐institutional experience with COVID‐19 convalescent plasma in children
Background and Objectives Convalescent COVID‐19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high‐titer CCP early in the disease course of patients who are expected to be antibody‐negative; however, pediatric e...
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| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 2023-05, Vol.63 (5), p.918-924 |
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| creator | Jacquot, Cyril Gordon, Oren Noland, Daniel Donowitz, Jeffrey R. Levy, Emily Jain, Sanjay Willis, Zachary Rimland, Casey Loi, Michele Arrieta, Antonio Annen, Kyle Drapeau, Noelle Osborne, Stephanie Ardura, Monica I. Arora, Satyam Zivick, Elise Delaney, Meghan |
| description | Background and Objectives
Convalescent COVID‐19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high‐titer CCP early in the disease course of patients who are expected to be antibody‐negative; however, pediatric experience is limited. We created a multi‐institutional registry to characterize pediatric patients ( |
| doi_str_mv | 10.1111/trf.17318 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10175190</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2791381711</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4098-272ce046d36dbe4b94c825ce81f877ae7a71e1d5251deb99fffd01424f788f623</originalsourceid><addsrcrecordid>eNp1kc9OVDEUhxsigXF0wQuYm7jRxYWe3j9tV8SMIiQQjEG3Taf31Cnp9I7tvSA7H8Fn9EkoDBAgoZsuztcvv54fITtAdyGfvSHaXeAViA0ygabiJZOyeUUmlNZQAlRsm7xO6ZxSyiSFLbJdtbJt8osJ-XYy-sH9__vPhTS4YRxcH7Qv8M8Ko8NgsLh0w6KYnf48-pwpkIXpw4X2mAyGoVh5nZa6cKEwC-e7iOEN2bTaJ3x7d0_Jj4MvZ7PD8vj069Hs03FpaipFyTgzSOu2q9pujvVc1kawxqAAKzjXyDUHhK5hDXQ4l9Ja21GoWW25ELZl1ZTsr72rcb7E7iZN1F6tolvqeKV67dTTSXAL9au_UECBNyBpNny4M8T-94hpUEuXf-W9DtiPSTEuoRLA8wKn5P0z9LwfY15UpkSeS0obnqmPa8rEPqWI9iENUHVTlMpFqduiMvvucfwH8r6ZDOytgUvn8eplkzr7frBWXgNCa59T</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2811390057</pqid></control><display><type>article</type><title>Multi‐institutional experience with COVID‐19 convalescent plasma in children</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Jacquot, Cyril ; Gordon, Oren ; Noland, Daniel ; Donowitz, Jeffrey R. ; Levy, Emily ; Jain, Sanjay ; Willis, Zachary ; Rimland, Casey ; Loi, Michele ; Arrieta, Antonio ; Annen, Kyle ; Drapeau, Noelle ; Osborne, Stephanie ; Ardura, Monica I. ; Arora, Satyam ; Zivick, Elise ; Delaney, Meghan</creator><creatorcontrib>Jacquot, Cyril ; Gordon, Oren ; Noland, Daniel ; Donowitz, Jeffrey R. ; Levy, Emily ; Jain, Sanjay ; Willis, Zachary ; Rimland, Casey ; Loi, Michele ; Arrieta, Antonio ; Annen, Kyle ; Drapeau, Noelle ; Osborne, Stephanie ; Ardura, Monica I. ; Arora, Satyam ; Zivick, Elise ; Delaney, Meghan</creatorcontrib><description>Background and Objectives
Convalescent COVID‐19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high‐titer CCP early in the disease course of patients who are expected to be antibody‐negative; however, pediatric experience is limited. We created a multi‐institutional registry to characterize pediatric patients (<18 years) who received CCP and to assess the safety of this intervention.
Methods
A REDCap survey was distributed. The registry collected de‐identified data including demographic information (age, gender, and underlying conditions), COVID‐19 disease features and concurrent treatments, CCP transfusion and safety events, and therapy response.
Results
Ninety‐five children received CCP: 90 inpatients and 5 outpatients, with a median age of 10.2 years (range 0–17.9). They were predominantly Latino/Hispanic and White. The most frequent underlying medical conditions were chronic respiratory disease, immunosuppression, obesity, and genetic syndromes. CCP was primarily given as a treatment (95%) rather than prophylaxis (5%). Median total plasma dose administered and transfusion rates were 5.0 ml/kg and 2.6 ml/kg/h, respectively. The transfusions were well‐tolerated, with 3 in 115 transfusions reporting mild reactions. No serious adverse events were reported. Severity scores decreased significantly 7 days after CCP transfusion or at discharge. Eighty‐five patients (94.4%) survived to hospital discharge. All five outpatients survived to 60 days.
Conclusions
CCP was found to be safe and well‐tolerated in children. CCP was frequently given concurrently with other COVID‐19‐directed treatments with improvement in clinical severity scores ≥7 days after CCP, but efficacy could not be evaluated in this study.</description><identifier>ISSN: 0041-1132</identifier><identifier>ISSN: 1537-2995</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.17318</identifier><identifier>PMID: 36965173</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adolescent ; Adult ; Antibodies ; Blood Transfusion ; Child ; Child, Preschool ; Children ; COVID-19 ; COVID-19 - etiology ; COVID-19 - therapy ; COVID-19 Serotherapy ; COVID‐19 convalescent plasma ; Health services ; Humans ; Immunity (passive) ; Immunization, Passive - adverse effects ; Immunosuppression ; Infant ; Infant, Newborn ; Patients ; pediatric transfusion ; Pediatrics ; Prophylaxis ; Respiratory diseases ; Safety ; SARS-CoV-2 ; Transfusion ; transfusion safety</subject><ispartof>Transfusion (Philadelphia, Pa.), 2023-05, Vol.63 (5), p.918-924</ispartof><rights>2023 AABB.</rights><rights>2023 AABB</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4098-272ce046d36dbe4b94c825ce81f877ae7a71e1d5251deb99fffd01424f788f623</citedby><cites>FETCH-LOGICAL-c4098-272ce046d36dbe4b94c825ce81f877ae7a71e1d5251deb99fffd01424f788f623</cites><orcidid>0000-0001-8447-7663 ; 0000-0003-1089-5787 ; 0000-0002-9048-5624 ; 0000-0003-1281-0644</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftrf.17318$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftrf.17318$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,777,781,882,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36965173$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacquot, Cyril</creatorcontrib><creatorcontrib>Gordon, Oren</creatorcontrib><creatorcontrib>Noland, Daniel</creatorcontrib><creatorcontrib>Donowitz, Jeffrey R.</creatorcontrib><creatorcontrib>Levy, Emily</creatorcontrib><creatorcontrib>Jain, Sanjay</creatorcontrib><creatorcontrib>Willis, Zachary</creatorcontrib><creatorcontrib>Rimland, Casey</creatorcontrib><creatorcontrib>Loi, Michele</creatorcontrib><creatorcontrib>Arrieta, Antonio</creatorcontrib><creatorcontrib>Annen, Kyle</creatorcontrib><creatorcontrib>Drapeau, Noelle</creatorcontrib><creatorcontrib>Osborne, Stephanie</creatorcontrib><creatorcontrib>Ardura, Monica I.</creatorcontrib><creatorcontrib>Arora, Satyam</creatorcontrib><creatorcontrib>Zivick, Elise</creatorcontrib><creatorcontrib>Delaney, Meghan</creatorcontrib><title>Multi‐institutional experience with COVID‐19 convalescent plasma in children</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>Background and Objectives
Convalescent COVID‐19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high‐titer CCP early in the disease course of patients who are expected to be antibody‐negative; however, pediatric experience is limited. We created a multi‐institutional registry to characterize pediatric patients (<18 years) who received CCP and to assess the safety of this intervention.
Methods
A REDCap survey was distributed. The registry collected de‐identified data including demographic information (age, gender, and underlying conditions), COVID‐19 disease features and concurrent treatments, CCP transfusion and safety events, and therapy response.
Results
Ninety‐five children received CCP: 90 inpatients and 5 outpatients, with a median age of 10.2 years (range 0–17.9). They were predominantly Latino/Hispanic and White. The most frequent underlying medical conditions were chronic respiratory disease, immunosuppression, obesity, and genetic syndromes. CCP was primarily given as a treatment (95%) rather than prophylaxis (5%). Median total plasma dose administered and transfusion rates were 5.0 ml/kg and 2.6 ml/kg/h, respectively. The transfusions were well‐tolerated, with 3 in 115 transfusions reporting mild reactions. No serious adverse events were reported. Severity scores decreased significantly 7 days after CCP transfusion or at discharge. Eighty‐five patients (94.4%) survived to hospital discharge. All five outpatients survived to 60 days.
Conclusions
CCP was found to be safe and well‐tolerated in children. CCP was frequently given concurrently with other COVID‐19‐directed treatments with improvement in clinical severity scores ≥7 days after CCP, but efficacy could not be evaluated in this study.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antibodies</subject><subject>Blood Transfusion</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>COVID-19</subject><subject>COVID-19 - etiology</subject><subject>COVID-19 - therapy</subject><subject>COVID-19 Serotherapy</subject><subject>COVID‐19 convalescent plasma</subject><subject>Health services</subject><subject>Humans</subject><subject>Immunity (passive)</subject><subject>Immunization, Passive - adverse effects</subject><subject>Immunosuppression</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Patients</subject><subject>pediatric transfusion</subject><subject>Pediatrics</subject><subject>Prophylaxis</subject><subject>Respiratory diseases</subject><subject>Safety</subject><subject>SARS-CoV-2</subject><subject>Transfusion</subject><subject>transfusion safety</subject><issn>0041-1132</issn><issn>1537-2995</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9OVDEUhxsigXF0wQuYm7jRxYWe3j9tV8SMIiQQjEG3Taf31Cnp9I7tvSA7H8Fn9EkoDBAgoZsuztcvv54fITtAdyGfvSHaXeAViA0ygabiJZOyeUUmlNZQAlRsm7xO6ZxSyiSFLbJdtbJt8osJ-XYy-sH9__vPhTS4YRxcH7Qv8M8Ko8NgsLh0w6KYnf48-pwpkIXpw4X2mAyGoVh5nZa6cKEwC-e7iOEN2bTaJ3x7d0_Jj4MvZ7PD8vj069Hs03FpaipFyTgzSOu2q9pujvVc1kawxqAAKzjXyDUHhK5hDXQ4l9Ja21GoWW25ELZl1ZTsr72rcb7E7iZN1F6tolvqeKV67dTTSXAL9au_UECBNyBpNny4M8T-94hpUEuXf-W9DtiPSTEuoRLA8wKn5P0z9LwfY15UpkSeS0obnqmPa8rEPqWI9iENUHVTlMpFqduiMvvucfwH8r6ZDOytgUvn8eplkzr7frBWXgNCa59T</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Jacquot, Cyril</creator><creator>Gordon, Oren</creator><creator>Noland, Daniel</creator><creator>Donowitz, Jeffrey R.</creator><creator>Levy, Emily</creator><creator>Jain, Sanjay</creator><creator>Willis, Zachary</creator><creator>Rimland, Casey</creator><creator>Loi, Michele</creator><creator>Arrieta, Antonio</creator><creator>Annen, Kyle</creator><creator>Drapeau, Noelle</creator><creator>Osborne, Stephanie</creator><creator>Ardura, Monica I.</creator><creator>Arora, Satyam</creator><creator>Zivick, Elise</creator><creator>Delaney, Meghan</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8447-7663</orcidid><orcidid>https://orcid.org/0000-0003-1089-5787</orcidid><orcidid>https://orcid.org/0000-0002-9048-5624</orcidid><orcidid>https://orcid.org/0000-0003-1281-0644</orcidid></search><sort><creationdate>202305</creationdate><title>Multi‐institutional experience with COVID‐19 convalescent plasma in children</title><author>Jacquot, Cyril ; Gordon, Oren ; Noland, Daniel ; Donowitz, Jeffrey R. ; Levy, Emily ; Jain, Sanjay ; Willis, Zachary ; Rimland, Casey ; Loi, Michele ; Arrieta, Antonio ; Annen, Kyle ; Drapeau, Noelle ; Osborne, Stephanie ; Ardura, Monica I. ; Arora, Satyam ; Zivick, Elise ; Delaney, Meghan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4098-272ce046d36dbe4b94c825ce81f877ae7a71e1d5251deb99fffd01424f788f623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antibodies</topic><topic>Blood Transfusion</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>COVID-19</topic><topic>COVID-19 - etiology</topic><topic>COVID-19 - therapy</topic><topic>COVID-19 Serotherapy</topic><topic>COVID‐19 convalescent plasma</topic><topic>Health services</topic><topic>Humans</topic><topic>Immunity (passive)</topic><topic>Immunization, Passive - adverse effects</topic><topic>Immunosuppression</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Patients</topic><topic>pediatric transfusion</topic><topic>Pediatrics</topic><topic>Prophylaxis</topic><topic>Respiratory diseases</topic><topic>Safety</topic><topic>SARS-CoV-2</topic><topic>Transfusion</topic><topic>transfusion safety</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacquot, Cyril</creatorcontrib><creatorcontrib>Gordon, Oren</creatorcontrib><creatorcontrib>Noland, Daniel</creatorcontrib><creatorcontrib>Donowitz, Jeffrey R.</creatorcontrib><creatorcontrib>Levy, Emily</creatorcontrib><creatorcontrib>Jain, Sanjay</creatorcontrib><creatorcontrib>Willis, Zachary</creatorcontrib><creatorcontrib>Rimland, Casey</creatorcontrib><creatorcontrib>Loi, Michele</creatorcontrib><creatorcontrib>Arrieta, Antonio</creatorcontrib><creatorcontrib>Annen, Kyle</creatorcontrib><creatorcontrib>Drapeau, Noelle</creatorcontrib><creatorcontrib>Osborne, Stephanie</creatorcontrib><creatorcontrib>Ardura, Monica I.</creatorcontrib><creatorcontrib>Arora, Satyam</creatorcontrib><creatorcontrib>Zivick, Elise</creatorcontrib><creatorcontrib>Delaney, Meghan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacquot, Cyril</au><au>Gordon, Oren</au><au>Noland, Daniel</au><au>Donowitz, Jeffrey R.</au><au>Levy, Emily</au><au>Jain, Sanjay</au><au>Willis, Zachary</au><au>Rimland, Casey</au><au>Loi, Michele</au><au>Arrieta, Antonio</au><au>Annen, Kyle</au><au>Drapeau, Noelle</au><au>Osborne, Stephanie</au><au>Ardura, Monica I.</au><au>Arora, Satyam</au><au>Zivick, Elise</au><au>Delaney, Meghan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multi‐institutional experience with COVID‐19 convalescent plasma in children</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2023-05</date><risdate>2023</risdate><volume>63</volume><issue>5</issue><spage>918</spage><epage>924</epage><pages>918-924</pages><issn>0041-1132</issn><issn>1537-2995</issn><eissn>1537-2995</eissn><abstract>Background and Objectives
Convalescent COVID‐19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high‐titer CCP early in the disease course of patients who are expected to be antibody‐negative; however, pediatric experience is limited. We created a multi‐institutional registry to characterize pediatric patients (<18 years) who received CCP and to assess the safety of this intervention.
Methods
A REDCap survey was distributed. The registry collected de‐identified data including demographic information (age, gender, and underlying conditions), COVID‐19 disease features and concurrent treatments, CCP transfusion and safety events, and therapy response.
Results
Ninety‐five children received CCP: 90 inpatients and 5 outpatients, with a median age of 10.2 years (range 0–17.9). They were predominantly Latino/Hispanic and White. The most frequent underlying medical conditions were chronic respiratory disease, immunosuppression, obesity, and genetic syndromes. CCP was primarily given as a treatment (95%) rather than prophylaxis (5%). Median total plasma dose administered and transfusion rates were 5.0 ml/kg and 2.6 ml/kg/h, respectively. The transfusions were well‐tolerated, with 3 in 115 transfusions reporting mild reactions. No serious adverse events were reported. Severity scores decreased significantly 7 days after CCP transfusion or at discharge. Eighty‐five patients (94.4%) survived to hospital discharge. All five outpatients survived to 60 days.
Conclusions
CCP was found to be safe and well‐tolerated in children. CCP was frequently given concurrently with other COVID‐19‐directed treatments with improvement in clinical severity scores ≥7 days after CCP, but efficacy could not be evaluated in this study.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36965173</pmid><doi>10.1111/trf.17318</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8447-7663</orcidid><orcidid>https://orcid.org/0000-0003-1089-5787</orcidid><orcidid>https://orcid.org/0000-0002-9048-5624</orcidid><orcidid>https://orcid.org/0000-0003-1281-0644</orcidid></addata></record> |
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| identifier | ISSN: 0041-1132 |
| ispartof | Transfusion (Philadelphia, Pa.), 2023-05, Vol.63 (5), p.918-924 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Antibodies Blood Transfusion Child Child, Preschool Children COVID-19 COVID-19 - etiology COVID-19 - therapy COVID-19 Serotherapy COVID‐19 convalescent plasma Health services Humans Immunity (passive) Immunization, Passive - adverse effects Immunosuppression Infant Infant, Newborn Patients pediatric transfusion Pediatrics Prophylaxis Respiratory diseases Safety SARS-CoV-2 Transfusion transfusion safety |
| title | Multi‐institutional experience with COVID‐19 convalescent plasma in children |
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