RT Journal Article SR Electronic T1 Timing of convalescent plasma administration and 28-day mortality in COVID-19 pneumonia JF Journal of Investigative Medicine JO J Investig Med FD BMJ Publishing Group Ltd SP 1258 OP 1264 DO 10.1136/jim-2021-002158 VO 70 IS 5 A1 Soledad E González A1 Lorena Regairaz A1 Martin R Salazar A1 Noelia S Ferrando A1 Verónica V González Martínez A1 Patricia M Carrera Ramos A1 Santiago A Pesci A1 Juan M Vidal A1 Nicolás Kreplak A1 Elisa Estenssoro YR 2022 UL http://hw-f5-jim.highwire.org/content/70/5/1258.abstract AB 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.