Abstract
PURPOSE: Convalescent plasma (CP), obtained from individuals who have recovered from COVID-19, has been widely explored as a potential therapeutic option, particularly in the absence of vaccines and monoclonal antibody treatments. This study aimed to evaluate the effectiveness of CP therapy in improving survival among non-immunized COVID-19 patients hospitalized in Brazil. METHODS: This retrospective unicentric cohort study was conducted at a private hospital in Campo Largo, Paraná, Brazil, from July 2020 to February 2021. A total of 245 hospitalized COVID-19 patients were included, confirmed by RT-qPCR or antigen testing. Patients were divided into two groups: those receiving CP alongside standard treatment (n=100) and those receiving standard treatment alone (n=145). Survival outcomes were assessed using Kaplan-Meier analysis and Cox regression, while inflammatory responses were evaluated through C-reactive protein (CRP) measurements. RESULTS: Patients treated with CP had a significantly higher survival rate (91%) compared to the control group (82.8%) (P=0.0363). The survival benefit persisted throughout the follow-up period, with a 2.25-fold lower risk of death in the CP group after adjusting for age (P=0.0480). However, no significant differences in CRP levels were observed between groups at discharge, suggesting that CP's benefits may be mediated through immune modulation rather than direct anti-inflammatory effects. CONCLUSIONS: Our findings indicate that CP therapy significantly improves survival in non-immunized COVID-19 patients, reinforcing its potential role in settings with limited access to advanced treatments. Future studies should explore CP's mechanisms of action and its integration into broader therapeutic strategies.