Franchini Massimo, Glingani Claudia, Morandi Mario, Corghi Giovanni, Cerzosimo Sara, Beduzzi Gloria, Storti Andrea, Di Stasi Vincenza, Rastrelli Giulia, Vignozzi Linda, Mengoli Carlo, Garuti Martina, Beccaria Massimiliano, Inglese Francesco, Caruso Beatrice, Petilino Roberto Antonio, Amato Massimo, Nicchio Michele, Pagani Mauro, Bellani Angela, Castelli Gianpaolo, Casari Salvatore, De Donno Giuseppe
Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy.
Green Park Residence, Mantova Salus Group, Mantova, Italy.
Mayo Clin Proc Innov Qual Outcomes. 2021 Apr;5(2):403-412. doi: 10.1016/j.mayocpiqo.2021.01.010. Epub 2021 Feb 8.
To assess the safety and efficacy of convalescent plasma (CP) transfusion in elderly people with moderate to severe coronavirus disease 2019 (COVID-19) living in a long-term care facility (LTCF).
Twenty-two consecutive elderly patients with COVID-19 infection living in an LTCF in Lombardy, Italy, who were given CP during May 15 to July 31, 2020, were enrolled in a prospective cohort study. Their clinical, instrumental, and laboratory parameters were assessed following the CP treatment. The overall mortality rate in this group was compared with that recorded in other LTCFs in Lombardy during the 3-month period from March to May 2020.
Of the 22 patients enrolled, 68.2% (n=15) received 1 CP unit, 27.3% (n=6) received 2 units, and 4.5% (n=1) received 3 units. Of the CP units transfused, 76.7% (23/30) had a neutralizing antibody titer of 1:160 or greater. No adverse reactions were recorded during or after CP administration. Improvements in clinical, functional, radiologic, and laboratory parameters during the 14 days after CP transfusion were observed in all 19 patients who survived. Viral clearance was achieved in all patients by the end of follow-up (median, 66 days; interquartile range, 48-80 days). The overall mortality rate was 13.6% (3/22), which compared favorably with that in the control group (38.3% [281/733]; =.02) and corresponded to a 65% reduction in mortality risk.
Early administration of CP with an adequate anti-severe acute respiratory syndrome coronavirus 2 antibody titer to elderly symptomatic patients with COVID-19 infection in an LTCF was safe and effective in eliminating the virus, restoring patients' immunity, and blocking the progression of COVID-19 infection, thereby improving patients' survival.
ClinicalTrials.gov: NCT04569188.
评估在长期护理机构（LTCF）中，对患有中度至重度2019冠状病毒病（COVID-19）的老年人输注康复期血浆（CP）的安全性和有效性。
2020年5月15日至7月31日期间，在意大利伦巴第大区一家LTCF中连续纳入22例感染COVID-19的老年患者，这些患者接受了CP治疗，并被纳入一项前瞻性队列研究。在CP治疗后，对他们的临床、影像学和实验室参数进行评估。将该组的总死亡率与2020年3月至5月这3个月期间伦巴第大区其他LTCF记录的死亡率进行比较。
在纳入的22例患者中，68.2%（n = 15）接受了1个CP单位，27.3%（n = 6）接受了2个单位，4.5%（n = 1）接受了3个单位。在输注的CP单位中，76.7%（23/30）的中和抗体滴度为1:160或更高。在CP输注期间或之后未记录到不良反应。在所有存活的19例患者中，观察到CP输注后14天内临床、功能、影像学和实验室参数有所改善。到随访结束时（中位数为66天；四分位间距为48 - 80天），所有患者均实现了病毒清除。总死亡率为13.6%（3/22），与对照组（38.3% [281/733]；P =.02）相比更有利，相当于死亡风险降低了65%。
对LTCF中感染COVID-19的有症状老年患者早期输注具有足够抗严重急性呼吸综合征冠状病毒2抗体滴度的CP，在消除病毒、恢复患者免疫力以及阻断COVID-19感染进展方面是安全有效的，从而提高了患者的生存率。
ClinicalTrials.gov：NCT04569188。
