New Findings Suggest CCP May Be ‘Futile’ for Critically Ill Patients

October 08, 2021

New research suggests that treatment with two units of high-titer, ABO-compatible COVID-19 convalescent plasma (CCP) may have a low likelihood of providing improvement in the number of organ support–free days among critically ill adults with confirmed COVID-19. The findings, published this week in JAMA, are the latest from REMAP-CAP (Randomised, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia), which has enrolled thousands of patients in hundreds of hospitals around the world to quickly determine what COVID-19 treatments work best in which patients.

REMAP-CAP’s CCP trial enrolled 2,011 adults hospitalized with severe COVID-19 who were randomized to receive either two units of CCP or placebo. The primary outcome was respiratory and cardiovascular organ support–free days up to day 21. The trial concluded due to futility when enough data was collected to say with greater than 99% certainty that CCP did not help critically ill COVID-19 patients.

According to investigators, the trial results are consistent with those of the RECOVERY trial, which found a lack of benefit of CCP for patients hospitalized with moderate or severe COVID-19. However, the authors noted that CCP may potentially benefit immunocompromised patients, although the small number of patients does not allow for a definitive statement. 

"It could be that patients with an impaired immune system, who are unable to mount an effective immune response, could still benefit from the antibodies present in blood plasma from COVID-recovered patients, especially early on in the illness," said corresponding author Lise Estcourt, MD. "This is something that definitely warrants investigation."