Trial Outcomes & Findings for Convalescent Plasma in Outpatients With COVID-19 (NCT NCT04355767)

NCT ID: NCT04355767

Last Updated: 2021-10-19

Results Overview

Disease progression defined as death or hospital admission or seeking emergency or urgent care within 15 days of randomization.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

511 participants

Primary outcome timeframe

15 days

Results posted on

2021-10-19

Participant Flow

Patients were enrolled at 48 hospital emergency departments in 21 states.

Participant milestones

Participant milestones
Measure
Convalescent Plasma
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Overall Study
STARTED
257
254
Overall Study
Intention-to-treat Population
257
254
Overall Study
Had Data for 15-day Outcome
257
254
Overall Study
COMPLETED
250
251
Overall Study
NOT COMPLETED
7
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Convalescent Plasma
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Overall Study
Withdrawal by Subject
2
2
Overall Study
Death
5
1

Baseline Characteristics

Convalescent Plasma in Outpatients With COVID-19

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Convalescent Plasma
n=257 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Total
n=511 Participants
Total of all reporting groups
Age, Continuous
54 years
n=5 Participants
54 years
n=7 Participants
54 years
n=5 Participants
Sex: Female, Male
Female
135 Participants
n=5 Participants
139 Participants
n=7 Participants
274 Participants
n=5 Participants
Sex: Female, Male
Male
122 Participants
n=5 Participants
115 Participants
n=7 Participants
237 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
83 Participants
n=5 Participants
73 Participants
n=7 Participants
156 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
170 Participants
n=5 Participants
179 Participants
n=7 Participants
349 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
8 Participants
n=5 Participants
10 Participants
n=7 Participants
18 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
49 Participants
n=5 Participants
54 Participants
n=7 Participants
103 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
28 Participants
n=5 Participants
25 Participants
n=7 Participants
53 Participants
n=5 Participants
Race/Ethnicity, Customized
White
172 Participants
n=5 Participants
165 Participants
n=7 Participants
337 Participants
n=5 Participants
Region of Enrollment
United States
257 Participants
n=5 Participants
254 Participants
n=7 Participants
511 Participants
n=5 Participants
Eligibility risk factor
Age .50 yr
155 Participants
n=5 Participants
155 Participants
n=7 Participants
310 Participants
n=5 Participants
Eligibility risk factor
Body-mass index ≥30
152 Participants
n=5 Participants
150 Participants
n=7 Participants
302 Participants
n=5 Participants
Eligibility risk factor
Hypertension
105 Participants
n=5 Participants
111 Participants
n=7 Participants
216 Participants
n=5 Participants
Eligibility risk factor
Current or former tobacco use
81 Participants
n=5 Participants
71 Participants
n=7 Participants
152 Participants
n=5 Participants
Eligibility risk factor
Diabetes mellitus
76 Participants
n=5 Participants
66 Participants
n=7 Participants
142 Participants
n=5 Participants
Eligibility risk factor
COPD or asthma
56 Participants
n=5 Participants
68 Participants
n=7 Participants
124 Participants
n=5 Participants
Eligibility risk factor
Coronary artery disease
28 Participants
n=5 Participants
23 Participants
n=7 Participants
51 Participants
n=5 Participants
Eligibility risk factor
Immunosuppression
33 Participants
n=5 Participants
17 Participants
n=7 Participants
50 Participants
n=5 Participants
Eligibility risk factor
Chronic lung disease
16 Participants
n=5 Participants
15 Participants
n=7 Participants
31 Participants
n=5 Participants
Eligibility risk factor
Chronic kidney disease
16 Participants
n=5 Participants
12 Participants
n=7 Participants
28 Participants
n=5 Participants
Eligibility risk factor
Congestive heart disease
9 Participants
n=5 Participants
11 Participants
n=7 Participants
20 Participants
n=5 Participants
Eligibility risk factor
Currently pregnant
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Eligibility risk factor
Organ transplant recipient
5 Participants
n=5 Participants
0 Participants
n=7 Participants
5 Participants
n=5 Participants
Eligibility risk factor
Active cancer
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Eligibility risk factor
Sickle-cell disease
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Number of eligibility risk factors
1
51 Participants
n=5 Participants
66 Participants
n=7 Participants
117 Participants
n=5 Participants
Number of eligibility risk factors
3
65 Participants
n=5 Participants
65 Participants
n=7 Participants
130 Participants
n=5 Participants
Number of eligibility risk factors
≥3
141 Participants
n=5 Participants
123 Participants
n=7 Participants
264 Participants
n=5 Participants
Other coexisting illness
Current or former alcohol abuse
20 Participants
n=5 Participants
16 Participants
n=7 Participants
36 Participants
n=5 Participants
Other coexisting illness
Current or former drug abuse
18 Participants
n=5 Participants
17 Participants
n=7 Participants
35 Participants
n=5 Participants
Other coexisting illness
Thromboembolic disorder
15 Participants
n=5 Participants
10 Participants
n=7 Participants
25 Participants
n=5 Participants
Other coexisting illness
Liver disease
12 Participants
n=5 Participants
6 Participants
n=7 Participants
18 Participants
n=5 Participants
Other coexisting illness
Other hematologic disorder
9 Participants
n=5 Participants
8 Participants
n=7 Participants
17 Participants
n=5 Participants
Symptom duration before randomization
4 days
n=5 Participants
3 days
n=7 Participants
4 days
n=5 Participants
Interval between randomization and infusion
92 minutes
n=5 Participants
69 minutes
n=7 Participants
81 minutes
n=5 Participants

PRIMARY outcome

Timeframe: 15 days

Population: Intention-to-treat population included all randomized participants.

Disease progression defined as death or hospital admission or seeking emergency or urgent care within 15 days of randomization.

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=257 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Number of Patients With Disease Progression (Intention-to-treat Population)
Patients with a disease-progression event
77 Participants
81 Participants
Number of Patients With Disease Progression (Intention-to-treat Population)
Hospital admission for any reason
51 Participants
56 Participants
Number of Patients With Disease Progression (Intention-to-treat Population)
Seeking emergency or urgent care
25 Participants
25 Participants
Number of Patients With Disease Progression (Intention-to-treat Population)
Death without hospitalization
1 Participants
0 Participants

PRIMARY outcome

Timeframe: 15 days

Population: Per-protocol population included all the patients who had undergone randomization after the exclusion of those who did not receive the assigned trial product, had an identified eligibility violation, or had a disease-progression event before the initiation of treatment.

Disease progression defined as death or hospital admission or seeking emergency or urgent care within 15 days of randomization.

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=246 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=251 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Number of Patients With Disease Progression (Per-protocol Population)
Patients with a disease-progression event
71 Participants
80 Participants
Number of Patients With Disease Progression (Per-protocol Population)
Hospital admission for any reason
47 Participants
55 Participants
Number of Patients With Disease Progression (Per-protocol Population)
Seeking emergency or urgent care
24 Participants
25 Participants
Number of Patients With Disease Progression (Per-protocol Population)
Death without hospitalization
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 30 days

Population: Participants with available data are included in the analysis.

This scale was developed by a special World Health Organization (WHO) committee for quantifying COVID-19 illness severity. * 1 = Not hospitalized without limitation in activity (no symptoms) * 2 = Not hospitalized with limitation in activity (continued symptoms) * 3 = Hospitalized not on supplemental oxygen * 4 = Hospitalized on supplemental oxygen by mask or nasal prongs * 5 = Hospitalized on non-invasive ventilation or high flow nasal cannula * 6 = Hospitalized, intubated and mechanically ventilated * 7 = Hospitalized, intubated, mechanically ventilated and requiring additional organ support (pressors, renal replacement therapy) * 8 = Death

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=250 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=248 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 1
55 Participants
55 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 2
141 Participants
133 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 3
12 Participants
17 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 5
6 Participants
5 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 8
5 Participants
1 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 4
28 Participants
35 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 6
1 Participants
0 Participants
Worst Severity Rating on the WHO COVID Ordinal Scale for Clinical Improvement During the 30 Days Following Randomization
Severity rating 7
2 Participants
2 Participants

SECONDARY outcome

Timeframe: 15 days

Population: Intention-to-treat population

Assessed on the COVID Outpatient Ordinal Outcome Scale censored at 15 days after randomization. Scale provides more granular detail for outpatients than the WHO scale (adapted from Harrell and Lindsell, 2020). Worsening of symptoms is defined as any subject admitted to the hospital (level 1), seen in the emergency room (level 2), a patient who reports increased symptoms of 2 levels on the scale over a 24 hour period, or a patient who reports increased symptoms of 1 level observed for a 48 hour period. COVID Outpatient Ordinal Outcomes Scale * 1 = patient requires care in the hospital * 2 = patient requires care in the emergency department or urgent care * 3 = patient at home with symptoms rated as moderate (defined as fever, shortness of breath, abdominal pain) * 4 = patient at home with symptoms rated as mild (defined as afebrile, constitutional symptoms (flu-like illness) without shortness * 5 = patient in their usual state of health

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=257 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Number of Patients With Worsening of Symptoms at Day 15 as a Measure of Time to Disease Progression
107 Participants
116 Participants

SECONDARY outcome

Timeframe: 30 days

Population: Intention-to-treat population

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=257 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Number of Hospital-free Days During the 30 Days Following Randomization
28.3 days
Standard Deviation 4.9
28.6 days
Standard Deviation 3.6

SECONDARY outcome

Timeframe: Assessed at 30 days

Population: Intention-to-treat population

Outcome measures

Outcome measures
Measure
Convalescent Plasma
n=257 Participants
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 Participants
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
All-cause Mortality
5 Participants
1 Participants

Adverse Events

Convalescent Plasma

Serious events: 59 serious events
Other events: 51 other events
Deaths: 5 deaths

Placebo

Serious events: 64 serious events
Other events: 35 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Convalescent Plasma
n=257 participants at risk
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 participants at risk
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Psychiatric disorders
Psychotic disorder
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Renal and urinary disorders
Acute kidney injury
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Blood and lymphatic system disorders
Anaemia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Cardiac disorders
Atrial fibrillation
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Cardiac disorders
Tachycardia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Gastrointestinal disorders
Abdominal pain
0.39%
1/257 • 30 days
0.39%
1/254 • 30 days
Gastrointestinal disorders
Vomiting
0.78%
2/257 • 30 days
0.00%
0/254 • 30 days
General disorders
Fatigue
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
General disorders
Influenza like illness
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Immune system disorders
Anaphylactic reaction
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Infections and infestations
Pneumonia
11.7%
30/257 • 30 days
15.4%
39/254 • 30 days
Infections and infestations
Septic shock
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Infections and infestations
Tooth abscess
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Infections and infestations
Viral diarrhoea
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Injury, poisoning and procedural complications
Infusion related reaction
1.6%
4/257 • 30 days
0.00%
0/254 • 30 days
Investigations
Oesophagoscopy
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Metabolism and nutrition disorders
Dehydration
0.78%
2/257 • 30 days
0.39%
1/254 • 30 days
Metabolism and nutrition disorders
Hyperglycemia
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Metabolism and nutrition disorders
Hyperkalaemia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Metabolism and nutrition disorders
Hyponatraemia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Nervous system disorders
Epilepsy
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Psychiatric disorders
Anxiety
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Renal and urinary disorders
End stage renal disease, could not get outpatient dialysis
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
1.2%
3/257 • 30 days
0.79%
2/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.39%
1/257 • 30 days
3.1%
8/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Epistaxis
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Haemoptysis
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Hypoxia
2.3%
6/257 • 30 days
2.0%
5/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
1.2%
3/257 • 30 days
0.79%
2/254 • 30 days
Vascular disorders
Hypotension
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Vascular disorders
Iliac artery occlusion
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Vascular disorders
Thrombophlebitis superficial
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days

Other adverse events

Other adverse events
Measure
Convalescent Plasma
n=257 participants at risk
Participants receive 1 unit of convalescent plasma (with neutralizing SARS-CoV2 antibodies) administered via intravenous (IV) infusion.
Placebo
n=254 participants at risk
Participants receive 1 unit of saline with multivitamin administered via intravenous (IV) infusion.
Ear and labyrinth disorders
Vertigo
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Gastrointestinal disorders
Abdominal pain
0.39%
1/257 • 30 days
0.79%
2/254 • 30 days
Gastrointestinal disorders
Dysphagia
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Gastrointestinal disorders
Vomiting
0.39%
1/257 • 30 days
1.2%
3/254 • 30 days
General disorders
Chest pain
1.2%
3/257 • 30 days
2.8%
7/254 • 30 days
General disorders
Fatigue
0.78%
2/257 • 30 days
0.00%
0/254 • 30 days
General disorders
Infusion site extravasation
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
General disorders
Pyrexia
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Infections and infestations
Nasopharyngitis
0.39%
1/257 • 30 days
0.39%
1/254 • 30 days
Infections and infestations
Pneumonia
2.7%
7/257 • 30 days
0.39%
1/254 • 30 days
Infections and infestations
Sinusitis
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Injury, poisoning and procedural complications
Alcohol poisoning
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Injury, poisoning and procedural complications
Fall
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Injury, poisoning and procedural complications
Infusion related reaction
4.3%
11/257 • 30 days
0.39%
1/254 • 30 days
Injury, poisoning and procedural complications
Road traffic accident
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Investigations
Coronavirus test positive
0.39%
1/257 • 30 days
0.79%
2/254 • 30 days
Metabolism and nutrition disorders
Decreased appetite
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Metabolism and nutrition disorders
Dehydration
0.00%
0/257 • 30 days
0.79%
2/254 • 30 days
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Musculoskeletal and connective tissue disorders
Flank pain
0.78%
2/257 • 30 days
0.00%
0/254 • 30 days
Nervous system disorders
Dizziness
0.78%
2/257 • 30 days
0.39%
1/254 • 30 days
Nervous system disorders
Migraine
1.2%
3/257 • 30 days
0.39%
1/254 • 30 days
Nervous system disorders
Presyncope
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Psychiatric disorders
Depression
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Psychiatric disorders
Paranoia
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days
Renal and urinary disorders
Nephrolithiasis
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Asthma
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Bronchospasm
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/257 • 30 days
1.2%
3/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Dyspnea
1.9%
5/257 • 30 days
3.5%
9/254 • 30 days
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.00%
0/257 • 30 days
1.2%
3/254 • 30 days
Skin and subcutaneous tissue disorders
Ecchymosis
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Skin and subcutaneous tissue disorders
Rash
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Surgical and medical procedures
Tooth extraction
0.39%
1/257 • 30 days
0.00%
0/254 • 30 days
Vascular disorders
Venous thrombosis limb
0.00%
0/257 • 30 days
0.39%
1/254 • 30 days

Additional Information

Kevin Schulman, MD

Stanford University

Phone: (650) 724-0543

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place