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新冠康复期血浆输注与危重症COVID-19患者临床改善相关:一项初步研究。

INFUSION OF CONVALESCENT PLASMA IS ASSOCIATED WITH CLINICAL IMPROVEMENT IN CRITICALLY ILL PATIENTS WITH COVID-19: A PILOT STUDY.

作者信息

Olivares-Gazca Juan C, Priesca-Marín Jose M, Ojeda-Laguna Martín, Garces-Eisele Javier, Soto-Olvera Silvia, Palacios-Alonso Abraham, Izquierdo-Vega Judith, Chacon-Cano Rómulo, Arizpe-Bravo Daniel, López-Trujillo Miguel A, Cantero-Fortiz Yahveth, Fernandez-Lara Danitza, Ruiz-Delgado Guillermo J, Ruiz-Argüelles Guillermo J

机构信息

Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Pue, Mexico.

Universidad Popular Autónoma del Estado de Puebla, Puebla, Pue, Mexico.

出版信息

Rev Invest Clin. 2020;72(3):159-164. doi: 10.24875/RIC.20000237.

Abstract

BACKGROUND

The ideal treatment of coronavirus disease (COVID)-19 has yet to be defined, but convalescent plasma (CoPla) has been successfully employed.

OBJECTIVE

The objective of the study was to study the safety and outcomes of the administration of CoPla to individuals with severe COVID-19 in an academic medical center.

METHODS

Ten patients were prospectively treated with plasma from COVID-19 convalescent donors.

RESULTS

Over 8 days, the sequential organ failure assessment score dropped significantly in all patients, from 3 to 1.5 (p = 0.014); the Kirby index (PaO/FiO) score increased from 124 to 255, (p < 0.0001), body temperature decreased significantly from 38.1 to 36.9°C (p = 0.0058), and ferritin levels also dropped significantly from 1736.6 to 1061.8 ng/ml (p = 0.0001). Chest X-rays improved in 7/10 cases and in 6/10, computerized tomography scans also revealed improvement of the lung injury. Decreases in C-reactive protein and D-dimer levels were also observed. Three of five patients on mechanical ventilation support could be extubated, nine were transferred to conventional hospital floors, and six were sent home; two patients died. The administration of CoPla had no side effects and the 24-day overall survival was 77%.

CONCLUSIONS

Although other treatments were also administered to the patients and as a result data are difficult to interpret, it seems that the addition of CoPla improved pulmonary function.

摘要

背景

冠状病毒病(COVID)-19的理想治疗方法尚未确定,但康复期血浆(CoPla)已成功应用。

目的

本研究的目的是在一家学术医疗中心研究对重症COVID-19患者输注CoPla的安全性和疗效。

方法

前瞻性地对10例患者使用来自COVID-19康复者捐献者的血浆进行治疗。

结果

在8天内,所有患者的序贯器官衰竭评估评分显著下降,从3降至1.5(p = 0.014);柯比指数(PaO/FiO)评分从124升至255(p < 0.0001),体温从38.1°C显著降至36.9°C(p = 0.0058),铁蛋白水平也从1736.6 ng/ml显著降至1061.8 ng/ml(p = 0.0001)。10例中有7例胸部X光片改善,10例中有6例计算机断层扫描也显示肺损伤有所改善。还观察到C反应蛋白和D-二聚体水平下降。5例接受机械通气支持的患者中有3例可以拔管,9例转至普通病房,6例出院;2例患者死亡。输注CoPla没有副作用,24天总生存率为77%。

结论

尽管患者也接受了其他治疗,因此数据难以解读,但似乎添加CoPla改善了肺功能。

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