Preemptive Use of Convalescent Plasma for High-risk Patients With COVID-19

Inclusion Criteria: 1. Immunocompromised patients defined as 1. Solid organ transplant ≤1 year before inclusion or treated for acute or chronic rejection episode or 2. Allogeneic stem cell transplant recipients ≤2 years before inclusion or treated for acute GvHD ≥grade 2 or chronic moderate-severe GvHD or 3. Active solid or haematological oncological disease with curative perspectives or 4. HIV infection with CD4\<350 or 5. Hypogammaglobulinemia and other severe genetic immunological defect or 6. Auto-immune disease with biological immunosuppressive treatment\* or 7. Other significant immunosuppressive condition such as IgG \<6, treamtent with Rituximab or other biological lymphopenic treatment AND * Age ≥ 18 years old and * 2 distinct ABO group determination and * Positive RT-PCR for SARS-CoV-2 on a respiratory tract sample of ≤ 7 days and days post symptom onset (DPOS) ≤ 7 days at inclusion and/or * No oxygen requirement (WHO 8 ordinal scale \< 4): asymptomatic, mild or moderate disease, or O2 saturation ≥ 90% at room temperature and * Compatible ABO donor with neutralizing antibodies (NTAB) ≥1 :160 or equivalent according to predefined antibody commercial assays cut-offs (see Study procedures) * RT-PCR on a respiratory tract sample with CT value\<20 or ascending kinetics at the time of infusion (highly suggested but not necessary) 2. Older adults defined as Age ≥ 75 years old or ≥ 65 years old with at least one co-existing condition * Arterial hypertension under pharmacological treatment * Diabetes in treatment * Obesity (BMI ≥ 30 kg/m2) * Chronic obstructive pulmonary disease stade GOLD ≥2 * Respiratory insufficiency due to any pneumopathy or neurologic disease. * Cardiovascular disease as defined by either known coronary heart disease, history of ischemic or hemorrhagic stroke or cardiac insufficiency (ejection fraction \<40%) * Chronic kidney disease (GFR\<60 ml/min) AND * 2 distinct ABO group determination and * Positive RT-PCR for SARS-CoV-2 on a respiratory tract sample of ≤ 3 days and days post symptom onset (DPOS) ≤ 3 days at inclusion or RT-PCR on a respiratory tract sample with CT value\<20 or ascending kinetics at the time of perfusion and * No additional oxygen requirement compared to baseline (WHO 8 ordinal scale \< 4): asymptomatic, mild or moderate disease and * Compatible ABO donor with neutralizing antibodies (NTAB) ≥1 :160 or equivalent according to predefined antibody commercial assays cut-offs (see Study procedures) Exclusion criteria: Seroconversion at the time of inclusion * Palliative care * No signed informed consent * History of previous transfusion-related Grade 3 adverse event according to Swissmedic definitions * Disseminated intravascular coagulopathy (depending on specialist evaluation) * Uncontrolled acute hypervolemia