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Author Notes:

S.R.S. and C.D.J. contributed equally to this study.

Contribution: Z.R., S.R.S., and C.D.J. conceived of and wrote the manuscript; S.R.S., C.D.J., Z.R., M.S., and J.W. prepared the figures; A.L.S., H.V., C.L., M.G.Z., M.S., J.W., H.M., M.W., S.C., J.D.R., C.M.A., S.R.S., and C.D.J. critically reviewed, analyzed, and interpreted the data; M.G.Z., J.W., M.S., H.M., C.M.A., and S.R.S. performed the immunologic assays; and C.L. collected the donor units and information on blood donors.

Zahidee Rodriguez, Emory University, Children’s Healthcare of Atlanta–Egleston, 1405 Clifton Rd, 2nd Floor, Tower 1, Atlanta, GA 30322; e-mail: rodriquezz@kidsheart.com

The authors thank their colleagues at LifeSouth for collection of donor plasma. Parental consent was obtained for treatment with C19-CP. Review of medical records, publication of results, and research use of biospecimens per the Declaration of Helsinki under the protocols were approved by the Institutional Review Board of Emory University School of Medicine and the Department of Health and Human Services.

The authors declare no competing financial interests.



  • Science & Technology
  • Life Sciences & Biomedicine
  • Hematology

COVID-19 convalescent plasma clears SARS-CoV-2 refractory to remdesivir in an infant with congenital heart disease

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Journal Title:



Volume 4, Number 18


, Pages 4278-4281

Type of Work:

Article | Final Publisher PDF


Although <2% of coronavirus disease 2019 (COVID-19) infections are reported in the pediatric population, children with comorbidities such as congenital heart disease and those at a younger age are more likely to become critically ill.1-3 Remdesivir has been reported to be efficacious in adults with COVID-194; however, there are no studies in children. Convalescent plasma (CP) can contain neutralizing antibodies to viruses,5 and has been used during previous viral epidemics with clinical improvement.6-11 COVID-19 CP (C19-CP) may be useful in critically ill adults, resulting in improvement in inflammatory markers, pulmonary lesions, and mortality.12 However, the impact of C19-CP in pediatric patients, particularly infants with developing immune systems and significant comorbidities, is completely unknown. We present an infant with cardiopulmonary failure secondary to unrepaired congenital heart disease exacerbated by COVID-19. Given postsurgical complications of children with viral respiratory infection,13-17 the patient required clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for surgical candidacy. We hypothesized that C19-CP administration may clear SARS-CoV-2 following failure of remdesivir.

Copyright information:

© 2020 by The American Society of Hematology

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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