treatment

COVID-19 Roundup: Convalescent Plasma, Ivermectin Efficacy, Aspirin Use

Convalescent Plasma1

Individuals with COVID-19 who are treated with convalescent plasma within 9 days of symptom onset may have a reduced risk of disease progression and hospitalization, according to the results of a recent study.

Included were 1225 adults who had tested positive for COVID-19 and were symptomatic from June 3, 2020, to October 1, 2021. All participants were enrolled within 8 days of symptom onset. A total of 1181 participants were randomly assigned to receive a transfusion of polyclonal convalescent plasma from survivors of COVID-19 or control plasma within 1 day after enrollment.

The primary outcome, COVID-19–related hospitalization within 28 days after transfusion, was observed in 2.9% (17 of 592) of the convalescent plasma group and 6.3% (37 of 589) of the control group. The relative risk reduction was 54%.

Of the total participants who were hospitalized, 53 were unvaccinated and 1 was partially vaccinated. Grade 3 or 4 adverse events among individuals who were not hospitalized were observed in 7 participants in the convalescent plasma group and 9 in the control group.

Ivermectin2

Individuals with COVID-19 who are treated with ivermectin may not have a lower risk of hospitalization or disease progression, according to the results of a recent adaptive platform trial.

To better understand the efficacy of ivermectin use in patients with symptomatic COVID-19, the researchers randomly assigned the 3315 participants to receive 1 of 3 treatments: ivermectin (n = 679), placebo (n = 679), or another treatment (n = 2157). All participants had at least 1 risk factor for disease progression to receive the 400 μg/kg dose of ivermectin daily. Participants must have had symptoms for up to 7 days to be included.

The results indicated that 14.7% (n = 100) of the ivermectin group and 16.3% (n = 111) of the placebo group were hospitalized or visited an emergency department with worsening COVID-19 symptoms within 28 days after randomization. Hospital admissions made up 81% (171 of 211) of the events measured by the primary outcome.

Aspirin Use3

Aspirin use in individuals with moderate COVID-19 within the first day of hospitalization may be associated with a lower risk of in-hospital mortality, according to the results of an observational cohort study.

The researchers utilized the National Institute of Health’s National COVID-19 Cohort Collaborative (N3C) to include 112,269 participants across 64 health systems in the United States from January 1, 2020, to September 10, 2021.

The results indicated that in-hospital mortality occurred in 10.9% of patients, with lower rates among those who received aspirin compared with those who did not receive aspirin (10.2% and 11.8% respectively, OR 0.85, 95% CI, 0.79-0.92, P < .001).

The rate of pulmonary embolism was also significantly lower among those who received aspirin. However, the rate of deep vein thrombosis was not lower among the aspirin group. The aspirin group did not have higher rates of gastrointestinal hemorrhage, cerebral hemorrhage, blood transfusion, or hemorrhagic complications.

 

—Leigh Precopio

 

References:

  1. Sullivan DJ, Gebo KA, Shoham S, et al. Early outpatient treatment for COVID-19 with convalescent plasma. N Engl J Med. Published online March 30, 2022. doi:10.1056/NEJMoa2119657
  2. Reis G, Silva E, Silva DCM, et al. Effect of early treatment with ivermectin among patients with COVID-19. N Engl J Med. Published online March 30, 2022. doi:10.1056/NEJMoa2115869
  3. Chow JH, Rahnavard A, Gomberg-Maitland M, et al. Association of early aspirin use with in-hospital mortality in patients with moderate COVID-19. JAMA Netw Open. 2022;5(3):e223890. doi:10.1001/jamanetworkopen.2022.3890

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