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康复期血浆疗法在治疗新冠肺炎方面似乎有效且安全。

Convalescent plasma appears efficacious and safe in COVID-19.

作者信息

Khulood Daulat, Adil Mir Shoebulla, Sultana Ruqiya

机构信息

Dr. NTR University of Health Sciences, Vijayawada, India.

Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta University Campus 1120 15th Street, HM BLDG, Augusta, GA 30912, USA.

出版信息

Ther Adv Infect Dis. 2020 Sep 28;7:2049936120957931. doi: 10.1177/2049936120957931. eCollection 2020 Jan-Dec.

Abstract

A cluster of pneumonia cases of unknown etiology associated with pyrexia and acute respiratory distress was identified in Southern China. Links between the previous severe acute respiratory syndrome (SARS) cases and the region's seafood market were noted with the possibility of a new zoonosis and SARS-CoV-2 was identified as the responsible agent. Currently, there are no effective prophylactic or therapeutic options to deal with coronavirus disease-19 (COVID-19) or any other human coronavirus (HCoV) infections. Convalescent plasma (CP) therapy is a classic adaptive immunotherapy which has been in use for more a century to prevent and treat infections including SARS, Middle East respiratory syndrome (MERS), and H1N1 pandemic. Moreover, the World Health Organization regarded CP transfusion as the most promising therapy to treat MERS-CoV. This review was undertaken to demonstrate the potential of CP in the treatment of the pandemic COVID-19 disease. A total of eight studies conducted on CP therapy in patients with COVID-19 were reviewed wherein 25,028 patients above 18 years of age were involved. The vast majority of patients reported favorable outcomes when treated with CP with <1% serious adverse events. Despite its promising beneficial effects in patients severely ill with COVID-19, CP therapy requires further evaluation in randomized clinical trials (RCTs) as a lack of satisfactory efficacy data from this area certainly enhances the hesitancy with regard to employing this treatment. In the present circumstances of unsatisfactory pharmacological therapy and the urgent need for a successful curative remedy, considering the use of CP therapy is reasonable provided RCTs confirm its safety, efficacy, and tolerability.

摘要

在中国南方发现了一组病因不明的肺炎病例,这些病例伴有发热和急性呼吸窘迫。注意到先前的严重急性呼吸综合征(SARS)病例与该地区的海鲜市场之间存在联系,有可能出现新的人畜共患病,并且已确定严重急性呼吸综合征冠状病毒2(SARS-CoV-2)为致病病原体。目前,尚无有效的预防或治疗方法来应对冠状病毒病-19(COVID-19)或任何其他人类冠状病毒(HCoV)感染。恢复期血浆(CP)疗法是一种经典的适应性免疫疗法,已经使用了一个多世纪来预防和治疗包括SARS、中东呼吸综合征(MERS)和H1N1大流行在内的感染。此外,世界卫生组织将CP输血视为治疗MERS-CoV最有前景的疗法。本综述旨在证明CP在治疗大流行的COVID-19疾病中的潜力。共综述了八项关于COVID-19患者CP疗法的研究,其中涉及25028名18岁以上的患者。绝大多数患者接受CP治疗后报告了良好的结果,严重不良事件发生率<1%。尽管CP疗法对重症COVID-19患者有有望带来有益效果,但由于该领域缺乏令人满意的疗效数据,肯定会增加采用这种治疗方法的犹豫,因此CP疗法需要在随机临床试验(RCT)中进一步评估。在目前药物治疗效果不理想且迫切需要成功治疗方法的情况下,如果RCT证实CP疗法的安全性、有效性和耐受性,考虑使用该疗法是合理的。

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