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治疗新型冠状病毒肺炎(COVID-19)患者的恢复期血浆。

Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma.

机构信息

Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.

Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pharmacy, Houston Methodist Hospital, Houston, Texas.

出版信息

Am J Pathol. 2020 Aug;190(8):1680-1690. doi: 10.1016/j.ajpath.2020.05.014. Epub 2020 May 27.

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has spread globally, and no proven treatments are available. Convalescent plasma therapy has been used with varying degrees of success to treat severe microbial infections for >100 years. Patients (n = 25) with severe and/or life-threatening COVID-19 disease were enrolled at the Houston Methodist hospitals from March 28, 2020, to April 14, 2020. Patients were transfused with convalescent plasma, obtained from donors with confirmed severe acute respiratory syndrome coronavirus 2 infection who had recovered. The primary study outcome was safety, and the secondary outcome was clinical status at day 14 after transfusion. Clinical improvement was assessed on the basis of a modified World Health Organization six-point ordinal scale and laboratory parameters. Viral genome sequencing was performed on donor and recipient strains. At day 7 after transfusion with convalescent plasma, nine patients had at least a one-point improvement in clinical scale, and seven of those were discharged. By day 14 after transfusion, 19 (76%) patients had at least a one-point improvement in clinical status, and 11 were discharged. No adverse events as a result of plasma transfusion were observed. Whole genome sequencing data did not identify a strain genotype-disease severity correlation. The data indicate that administration of convalescent plasma is a safe treatment option for those with severe COVID-19 disease.

摘要

2019 年冠状病毒病(COVID-19)是由严重急性呼吸系统综合症冠状病毒 2 引起的,目前已在全球范围内传播,尚无有效的治疗方法。多年来,恢复期血浆疗法已被用于治疗严重的微生物感染,并取得了不同程度的成功。

2020 年 3 月 28 日至 4 月 14 日,在休斯顿卫理公会医院招募了患有严重和/或危及生命的 COVID-19 疾病的 25 名患者。患者接受了来自已确认患有严重急性呼吸综合征冠状病毒 2 感染并已康复的供体的恢复期血浆输注。主要研究终点是安全性,次要终点是输注后 14 天的临床状况。临床改善基于改良的世界卫生组织六点等级量表和实验室参数进行评估。对供体和受体菌株进行了病毒基因组测序。

在输注恢复期血浆后的第 7 天,有 9 名患者的临床评分至少提高了 1 分,其中 7 名患者出院。在输注后第 14 天,19 名(76%)患者的临床状况至少提高了 1 分,其中 11 名出院。未观察到因血浆输注而导致的不良事件。全基因组测序数据未确定病毒株基因型与疾病严重程度的相关性。数据表明,恢复期血浆的使用是治疗严重 COVID-19 疾病的一种安全的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3839/7397457/8761510210cc/gr1.jpg

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