Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.
Department of Microbiology and Immunology and.
JCI Insight. 2021 Feb 22;6(4):142270. doi: 10.1172/jci.insight.142270.
Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) may hold promise as a treatment for coronavirus disease 2019 (COVID-19). We compared the mortality and clinical outcome of patients with COVID-19 who received 200 mL of CCP with a spike protein IgG titer ≥ 1:2430 (median 1:47,385) within 72 hours of admission with propensity score-matched controls cared for at a medical center in the Bronx, between April 13 and May 4, 2020. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroid use, and anticoagulation use. There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared with matched controls, CCP recipients less than 65 years had 4-fold lower risk of mortality and 4-fold lower risk of deterioration in oxygenation or mortality at day 28. For CCP recipients, pretransfusion spike protein IgG, IgM, and IgA titers were associated with mortality at day 28 in univariate analyses. No adverse effects of CCP were observed. Our results suggest CCP may be beneficial for hospitalized patients less than 65 years, but data from controlled trials are needed to validate this finding and establish the effect of aging on CCP efficacy.
恢复期含有严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）抗体的血浆（CCP）可能是治疗 2019 年冠状病毒病（COVID-19）的一种有希望的方法。我们比较了 2020 年 4 月 13 日至 5 月 4 日期间，在布朗克斯的一家医疗中心接受治疗的 COVID-19 患者在入院后 72 小时内接受 200 毫升 CCP 的死亡率和临床结果，这些患者的刺突蛋白 IgG 滴度≥1:2430（中位数为 1:47385），并与倾向性评分匹配的对照组进行比较。对照组的匹配标准为年龄、性别、体重指数、种族、民族、合并症、入院周、氧需求、D-二聚体、淋巴细胞计数、皮质类固醇使用和抗凝剂使用。在第 28 天，CCP 接受者和对照组之间的死亡率或氧合没有差异。按年龄分层后，与匹配的对照组相比，年龄小于 65 岁的 CCP 接受者的死亡率降低了 4 倍，氧合恶化或死亡率在第 28 天降低了 4 倍。在单变量分析中，CCP 接受者输血前的刺突蛋白 IgG、IgM 和 IgA 滴度与第 28 天的死亡率相关。未观察到 CCP 的不良反应。我们的结果表明，CCP 可能对 65 岁以下的住院患者有益，但需要进行对照试验的数据来验证这一发现，并确定年龄对 CCP 疗效的影响。
