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采集和评估恢复期血浆用于 COVID-19 治疗:为什么以及如何?

Collecting and evaluating convalescent plasma for COVID-19 treatment: why and how?

机构信息

Etablissement Français du Sang, La Plaine-St Denis, France.

UMR 1098 RIGHT, Inserm, EFS, Université de Franche-Comté, Besançon, France.

出版信息

Vox Sang. 2020 Aug;115(6):488-494. doi: 10.1111/vox.12926. Epub 2020 May 3.

Abstract

Plasma provided by COVID-19 convalescent patients may provide therapeutic relief as the number of COVID-19 cases escalates steeply worldwide. Prior findings in various viral respiratory diseases including SARS-CoV-related pneumonia suggest that convalescent plasma can reduce mortality, although formal proof of efficacy is still lacking. By reducing viral spread early on, such an approach may possibly downplay subsequent immunopathology. Identifying, collecting, qualifying and preparing plasma from convalescent patients with adequate SARS-CoV-2-neutralizing Ab titres in an acute crisis setting may be challenging, although well within the remit of most blood establishments. Careful clinical evaluation should allow to quickly establish whether such passive immunotherapy, administered at early phases of the disease in patients at high risk of deleterious evolution, may reduce the frequency of patient deterioration, and thereby COVID-19 mortality.

摘要

随着全球 COVID-19 病例急剧增加,COVID-19 恢复期患者的血浆可能提供治疗缓解。在包括 SARS-CoV 相关肺炎在内的各种病毒性呼吸道疾病中,先前的研究结果表明,恢复期血浆可以降低死亡率,尽管其疗效的正式证据仍然缺乏。通过早期减少病毒传播,这种方法可能会减轻随后的免疫病理。在急性危机情况下,从具有足够 SARS-CoV-2 中和抗体滴度的恢复期患者中识别、收集、定性和制备血浆可能具有挑战性,但这在大多数血液机构的职权范围内。仔细的临床评估应能快速确定这种被动免疫疗法是否可以在疾病早期对有不良进展风险的高危患者进行,以降低患者恶化的频率,从而降低 COVID-19 的死亡率。

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