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中国湖南新冠康复者血浆治疗COVID-19患者的疗效

Effectiveness of Convalescent Plasma Therapy for COVID-19 Patients in Hunan, China.

作者信息

Hu Xingsheng, Hu Chunhong, Jiang Dixuan, Zuo Qian, Li Ya, Wang Yang, Chen Xiangyu

机构信息

Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.

Department of Respiratory Medicine, The First Hospital of Changsha City, Changsha, Hunan, People's Republic of China.

出版信息

Dose Response. 2020 Dec 15;18(4):1559325820979921. doi: 10.1177/1559325820979921. eCollection 2020 Oct-Dec.

Abstract

OBJECTIVE

To investigate clinical efficacy and safety of convalescent plasma (CP) therapy in coronavirus disease 2019 (COVID-19) patients.

METHODS

We included 4 severe patients and 3 critical patients. The date of admission to hospital ranged from January 30 to February 19, 2020. We retrospectively collected clinical and outcome data. Relative parameters were compared.

RESULTS

After CP therapy, the symptoms and respiratory functions were improved. Median PaO/FIO increased from 254 (142-331) to 326 (163-364), and dependence of oxygen supply decreased. Median time to lesion's first absorption was 5 (2-7) days, undetectable viral RNA was 11 (3.5-15.7) days. Median lymphocyte count (0.77 × 10/L vs 0.85 × 10/L) and albumin level (31g/L vs 36 g/L) were elevated, C-reactive protein (44 mg/L vs 18 mg/L), D-dimer (5.9 mg/L vs 4 mg/L) and lactate dehydrogenase (263 U/L vs 245 U/L) decreased. No obvious adverse reactions were observed. At the follow-up on June 14, 2020, 6 patients had completely recovered and one died from terminal disease.

CONCLUSION

CP therapy for COVID-19 was effective and safe. Three patients who did not combine with antiviral therapy after CP also obtained viral clearance and clinical improvement. However, CP therapy failed to save the life of a terminally ill patient.

摘要

目的

探讨恢复期血浆(CP)疗法对2019冠状病毒病(COVID-19)患者的临床疗效及安全性。

方法

纳入4例重症患者和3例危重症患者。入院日期为2020年1月30日至2月19日。回顾性收集临床及转归数据,并比较相关参数。

结果

CP治疗后,患者症状及呼吸功能改善。氧合指数(PaO₂/FiO₂)中位数从254(142 - 331)升至326(163 - 364),氧疗依赖程度降低。肺部病灶首次吸收的中位时间为5(2 - 7)天,病毒RNA转阴时间为11(3.5 - 15.7)天。淋巴细胞计数中位数(0.77×10⁹/L对0.85×10⁹/L)及白蛋白水平(31g/L对36g/L)升高,C反应蛋白(44mg/L对18mg/L)、D-二聚体(5.9mg/L对4mg/L)及乳酸脱氢酶(263U/L对245U/L)降低。未观察到明显不良反应。2020年6月14日随访时,6例患者已完全康复,1例患者因终末期疾病死亡。

结论

CP疗法治疗COVID-19有效且安全。3例CP治疗后未联合抗病毒治疗的患者也实现了病毒清除及临床改善。然而,CP疗法未能挽救1例终末期患者的生命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/7745599/675ec4eec895/10.1177_1559325820979921-fig1.jpg

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