NARC: Plasma donation from convalescents increases survival from Covid-19

Early administration plasma from patients who have recovered results in the improvement in survival rates and the increased likelihood of extubation in patients with COVID-19. It must be selected for administration, plasma containing high-titer antibodies. This is the conclusion of a study that began in Greece in April 2020, under the auspices of National and Kapodistrian University of Athens (NKUA) with Thanos Dimopoulos, Rector of the National and Kapodistrian University of Athens, serving as principal investigator, with the participation of five hospitals in Athens, which aimed to investigate the efficacy and safety of plasma from patients who had recovered from SARS-CoV-2 in the treatment of patients with a severe form of COVID-19.

Professors at the University of Athens note that in February 2021, the U.S. Food and Drug Administration (FDA) amended the guidelines for the administration of plasma from recovered patients to patients hospitalized with symptomatic COVID-19 infection, adding that only plasma containing high titers of antibodies against SARS-CoV-2 should be used.

Findings from the National and Kapodistrian University of Athens study

According to the study, plasma from recovered patients—600 mL from each donor—was collected via plasmapheresis from volunteers who had fully recovered from SARS-CoV-2 and had developed antibodies. Antibody testing for the study was conducted at the Pasteur Institute, with the principal investigator being Andreas Menti and at the National Cancer Institute, with Professor Georgios Pavlakis. The plasma was frozen and stored at the National Blood Donation Center (under the supervision of Scientific Director Kostas Stamoulis), which was also responsible for distributing the plasma to the hospitals participating in the study to meet the patients’ needs.

The plasma was administered to patients with COVID-19 who had pulmonary involvement and required hospitalization for oxygen therapy, within 10 days of symptom onset. The study also included intubated patients, but only for a period not exceeding 72 hours after intubation. Patients received 3 doses of tumor plasma (200–233 ml) at one-day intervals between infusions, along with the appropriate supportive care.

The study was completed in February 2021 with the participation of 100 patients, who also constituted the study’s target population. The results from the first 60 patients were recently analyzed, and the findings of this study were published in the international journal *Microorganisms* (

National and Kapodistrian University of Athens professors Vasiliki Pappa, Evangelos Terpos, Marianna Politou, and Thanos Dimopoulos summarize the study’s most significant findings.

The results of the Greek study

After a median follow-up period of 28.5 days, 56 of the 60 patients (93%) who received plasma from COVID-19 survivors fully recovered and were discharged from the hospital, while only 3 of the 60 have died and one remains alive in the Intensive Care Unit. All patients who received plasma showed significant improvement in their clinical condition as well as in laboratory markers related to disease severity.

It was also found that, on the day following plasma administration, there was a significant increase in antibody titer that was associated with the exogenous administration of antibodies from convalescent plasma. A comparison of patients who received plasma with the group of patients receiving the same supportive care without plasma showed that mortality among patients who received plasma was significantly lower: 3.4% compared to 13.6% in the control group. Furthermore, the statistical analysis of the study showed that patients who received convalescent plasma had a significantly lower risk of death, significantly better survival, and a significantly higher chance of being extubated.

One notable finding of the study was that high antibody titers in the administered plasma were associated with significantly better patient survival, confirming the validity of the recent FDA guidance. Plasma administration was safe, and only one of the 60 patients experienced an adverse event involving shortness of breath and a decrease in oxygen levels that could not be safely attributed to the plasma. This adverse event resolved completely with appropriate conservative treatment.

The hospitals and research centers that participated in the study were:

• Alexandra General Hospital of Athens (E. Terpos, E. Korompoki, I. Haritaki, T. Sergentanis, I. Danasis-Stathopoulos, T. Bagratouni, and T. Dimopoulos)
• University Hospital «Aretaio» (M. Politou)
• «Attikon» University General Hospital (V. Pappas, A. Antoniadou, A. Bouhlas, T. Thomopoulos, S. Grigoropoulou, S. Papageorgiou, A. Bamias, and S. Tsiodras)
• Athens General Hospital «Evangelismos» (M. Pagoni, S. Saridakis, C. Giatra, E. Jahaj, I. Kalomenidis, and A. Kotanidou)
• University of Patras School of Medicine (A. Spyridonidis, G. Panagiotakopoulos)
• «Sotiria» General Hospital for Chest Diseases in Athens (A. Pefanis, G. Poulakou, I. Trontzas, and K. Syrigos)
• Athens Cancer Oncology Hospital «St. Savas» (E. Grouzi and D. Moshandreou)
• Pasteur Institute (A. Mentis and S. Lambropoulou)
• National Blood Donation Center (K. Stamoulis)
• NCI Retroviruses Section, USA (B.K. Felber, D. Stellas, M. Rosati, J. Bear, X. Hu, and G. Pavlakis)

Professors at the National and Kapodistrian University of Athens emphasize that the administration of plasma from patients who have recovered from COVID-19 to patients currently hospitalized with the disease, is one of the most important treatment options for combating SARS-CoV-2 coronavirus infection. At a time when COVID-19 cases are steadily rising worldwide and no effective treatment is in sight, the administration of ready-made antibodies against the virus—derived from the plasma of patients who have recovered from the disease—offers hope to those suffering from COVID-19.