Hatzl Stefan, Posch Florian, Sareban Nazanin, Stradner Martin, Rosskopf Konrad, Reisinger Alexander C, Eller Philipp, Schörghuber Michael, Toller Wolfgang, Sloup Zdenka, Prüller Florian, Gütl Katharina, Pilz Stefan, Rosenkranz Alexander R, Greinix Hildegard T, Krause Robert, Schlenke Peter, Schilcher Gernot
Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Ann Intensive Care. 2021 May 12;11(1):73. doi: 10.1186/s13613-021-00867-9.
This study aimed to quantify the potential survival benefit of convalescent plasma therapy (CVP) in critically ill patients with acute respiratory failure related to coronavirus disease-2019 (COVID-19).
This is a single-center prospective observational cohort study in COVID-19 patients with acute respiratory failure. Immediately after intensive care unit (ICU) admission patients were allocated to CVP treatment following pre-specified criteria to rapidly identify those patients potentially susceptible for this treatment. A propensity score adjustment [inverse probability of treatment weighted (IPTW) analysis] was implemented to account rigorously for imbalances in prognostic variables between the treatment groups.
We included 120 patients of whom 48 received CVP. Thirty percent were female with a median age of 66 years [25th-75th percentile 54-75]. Eighty-eight percent of patients presented with severe acute respiratory failure as displayed by a median paO/FiO ratio (Horowitz Index) of 92 [77-150]. All patients required any kind of ventilatory support with more than half of them (52%) receiving invasive ventilation. Thirty-day ICU overall survival (OS) was 69% in the CVP group and 54% in the non-CVP group (log-rank p = 0.049), respectively. After weighing the time-to-event data for the IPTW, the favorable association between CVP and OS became even stronger (log-rank p = 0.035). Moreover, an exploratory analysis showed an overall survival benefit of CVP therapy for patients with non-invasive ventilation (Hazard ratio 0.12 95% CI 0.03-0.57, p = 0.007) CONCLUSION: Administration of CVP in patients with acute respiratory failure related to COVID-19 is associated with improved ICU survival rates.
本研究旨在量化恢复期血浆疗法（CVP）对患有与2019冠状病毒病（COVID-19）相关的急性呼吸衰竭的危重症患者的潜在生存获益。
这是一项针对患有急性呼吸衰竭的COVID-19患者的单中心前瞻性观察队列研究。在重症监护病房（ICU）入院后，立即根据预先指定的标准将患者分配至CVP治疗组，以快速识别那些可能适合这种治疗的患者。采用倾向评分调整[治疗加权逆概率（IPTW）分析]来严格考虑治疗组之间预后变量的不平衡。
我们纳入了120例患者，其中48例接受了CVP治疗。30%为女性，中位年龄为66岁[第25-75百分位数为54-75]。88%的患者表现为严重急性呼吸衰竭，中位动脉血氧分压/吸入氧分数比（霍洛维茨指数）为92[77-150]。所有患者均需要某种形式的通气支持，其中超过一半（52%）接受有创通气。CVP组30天ICU总体生存率（OS）为69%，非CVP组为54%（对数秩检验p = 0.049）。在对IPTW的事件发生时间数据进行加权后，CVP与OS之间的有利关联变得更强（对数秩检验p = 0.035）。此外，一项探索性分析显示CVP疗法对接受无创通气的患者有总体生存获益（风险比0.12，95%置信区间0.03-0.57，p = 0.007）。结论：对与COVID-19相关的急性呼吸衰竭患者给予CVP治疗与ICU生存率提高相关。
Zotero 插件
