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COVID-19 恢复期血浆治疗 SARS-CoV-2 感染中、重度病例:一项多中心干预研究。

COVID-19 convalescent plasma treatment of moderate and severe cases of SARS-CoV-2 infection: A multicenter interventional study.

机构信息

Stem Cell Transplant Unit, Pediatric Hematology Oncology Department, National Bank Kuwait Specialized Children Hospital, Ministry of Health, Kuwait.

Neonatology Department, Farwaniya Hospital, Ministry of Health, Kuwait.

出版信息

Int J Infect Dis. 2021 Feb;103:439-446. doi: 10.1016/j.ijid.2020.11.198. Epub 2020 Dec 4.

Abstract

OBJECTIVE

To study the effectiveness of COVID-19 convalescent plasma (CCP) therapy for patients with moderate and severe COVID-19 disease.

METHODS

This non-randomized prospective cohort study was conducted from May 21 to June 30, 2020, at four major tertiary hospitals in Kuwait. CCP was administered to 135 patients. The control group comprised 233 patients who received standard treatment. All patients (N = 368, median age 54 [range 15-82]) had laboratory-confirmed SARS-CoV-2 infection and either moderate or severe COVID-19 disease.

RESULTS

CCP treatment was associated with a higher rate of clinical improvement in patients with moderate or severe disease. Among those with moderate COVID-19 disease, time to clinical improvement was 7 days in the CCP group, versus 8 days in the control group (p = 0·006). For severe COVID-19 disease, time to clinical improvement was 7 days in the CCP group, versus 15.5 days in the control group (p = 0·003). In the adjusted analysis, patients with moderate disease treated with CCP had a significantly lower 30-day mortality rate. Compared to the control group, oxygen saturation improved within 3 days of CCP transfusion, and lymphocyte counts improved from day 7 in patients with moderate COVID-19 disease and day 11 in patients with severe disease. C-reactive protein levels declined throughout the first 14 days after CCP transfusion. None of the CCP patients developed a serious transfusion reaction.

CONCLUSIONS

The data show that administration of CCP is a safe treatment option for patients with COVID-19 disease with a favorable outcome in the rate of, and time to, clinical improvement.

摘要

目的

研究 COVID-19 恢复期血浆(CCP)治疗中重度 COVID-19 患者的疗效。

方法

这是一项于 2020 年 5 月 21 日至 6 月 30 日在科威特四家主要三级医院进行的非随机前瞻性队列研究。给予 135 例患者 CCP。对照组包括 233 例接受标准治疗的患者。所有患者(N=368,中位年龄 54 岁[15-82 岁])均经实验室证实感染 SARS-CoV-2,且患有中重度 COVID-19 疾病。

结果

CCP 治疗与中重度疾病患者临床改善率较高相关。在中度 COVID-19 患者中,CCP 组临床改善时间为 7 天,而对照组为 8 天(p=0·006)。对于重度 COVID-19 疾病,CCP 组的临床改善时间为 7 天,而对照组为 15.5 天(p=0·003)。在调整分析中,接受 CCP 治疗的中度疾病患者 30 天死亡率显著降低。与对照组相比,CCP 输注后 3 天内血氧饱和度改善,中度 COVID-19 患者淋巴细胞计数从第 7 天开始改善,重度疾病患者从第 11 天开始改善。CCP 输注后第 14 天内 C 反应蛋白水平持续下降。未发生 CCP 患者出现严重输血反应。

结论

数据表明,给予 CCP 是 COVID-19 患者的一种安全治疗选择,可改善临床改善的速度和程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ac/7717772/543e88c3dad5/gr2_lrg.jpg

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