@article {Gonz{\'a}lez1258, author = {Soledad E Gonz{\'a}lez and Lorena Regairaz and Martin R Salazar and Noelia S Ferrando and Ver{\'o}nica V Gonz{\'a}lez Mart{\'\i}nez and Patricia M Carrera Ramos and Santiago A Pesci and Juan M Vidal and Nicol{\'a}s Kreplak and Elisa Estenssoro}, title = {Timing of convalescent plasma administration and 28-day mortality in COVID-19 pneumonia}, volume = {70}, number = {5}, pages = {1258--1264}, year = {2022}, doi = {10.1136/jim-2021-002158}, publisher = {BMJ Publishing Group Limited}, abstract = {This is a multicenter cohort study including consecutive, hospitalized patients >=18 years, with moderate to severe COVID-19, carried out to evaluate the relationship between the timing of convalescent plasma administration and 28-day mortality. Data were prospectively collected between May 14, 2020 and October 31, 2020. Patients were grouped according to the timing of administration of convalescent plasma as \<3 days, between 3 and 7 days, and \>7 days. The main outcome variable was 28-day mortality. Independent predictors of mortality were identified by logistic regression. Of 4719 patients receiving convalescent plasma, 3036 (64.3\%) were in the general ward, 1171 (24.8\%) in the intensive care unit (ICU), and 512 (10.8\%) in the ICU on mechanical ventilation. Convalescent plasma was administered to 3113 (66\%) patients within the first 3 days of hospital admission, to 1380 (29.2\%) between 3 and 7 days, and to 226 after 7 days; 28-day mortality was, respectively, 18.1\%, 30.4\% and 38.9\% (p\<0.001). In the regression model, convalescent plasma administration within the first 3 days of admission was associated with reduced 28-day mortality, compared with the administration after 7 days (OR 0.40, 95\% CI 0.30 to 0.53). Early convalescent plasma administration was associated to a significant decreased mortality in patients in the general ward (OR 0.45, 95\% CI 0.29 to 0.69) and in the ICU (OR 0.35, 95\% CI 0.19 to 0.64), but not in those requiring mechanical ventilation (OR 0.52, 95\% CI 0.27 to 1.01). In conclusion, this study suggests that early administration of convalescent plasma to patients with COVID-19 pneumonia is critical to obtain therapeutic benefit.Data are available upon reasonable request.}, issn = {1081-5589}, URL = {http://hw-f5-jim.highwire.org/content/70/5/1258}, eprint = {http://hw-f5-jim.highwire.org/content/70/5/1258.full.pdf}, journal = {Journal of Investigative Medicine} }