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接受恢复期血浆治疗的住院COVID-19患者预后的潜在预测因素:一项单中心研究。

Potential predictors of outcomes among hospitalized COVID-19 patients treated with convalescent plasma: a single-center study.

作者信息

Chilimuri Sridhar, Zahid Maleeha, Mantri Nikhitha, Sun Haozhe, Saleh Mohamed, Ashraf Shoaib, Gongati Sudharsan, Adrish Muhammad

机构信息

Department of Medicine, Bronx Care Health System, Bronx, NY, USA.

出版信息

J Community Hosp Intern Med Perspect. 2021 Jun 21;11(4):464-469. doi: 10.1080/20009666.2021.1941577.

DOI:10.1080/20009666.2021.1941577
PMID:34211649
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8221143/
Abstract

The coronavirus disease 2019 pandemic is a major international public health crisis, which has led to over 3 million deaths as of April 2021. Several therapeutics have been tried for this deadly illness including antivirals, immunosuppressive agents and convalescent plasma (CP). In this study, we present our inner-city safety net hospital experience with CP therapy. This was a retrospective chart review of hospitalized patients with confirmed COVID-19 who were treated with CP. A total of 60 patients received CP during the study period. The mean age for patients in this study was 58.95 years. The most common presenting symptoms were shortness of breath (85%) and cough (73%). Hypertension (65%) and diabetes mellitus (55%) were the most common comorbidities in our patients. In our multivariate regression analysis, male sex, nausea and loss of appetite at presentation were associated with improvement in oxygenation after CP. Total survival time, history of obstructive airway disease, home use of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers were associated with decreased survival, whereas Hispanic ethnicity showed a trend towards lower survival after CP therapy. Our study highlights several important characteristics of inner-city safety net hospital patient population who might benefit from CP therapy.

摘要

2019年冠状病毒病大流行是一场重大的国际公共卫生危机,截至2021年4月已导致超过300万人死亡。针对这种致命疾病已经尝试了多种治疗方法,包括抗病毒药物、免疫抑制剂和康复期血浆(CP)。在本研究中,我们介绍了我们在市中心安全网医院使用CP治疗的经验。这是一项对确诊为COVID-19且接受CP治疗的住院患者的回顾性病历审查。在研究期间,共有60名患者接受了CP治疗。本研究中患者的平均年龄为58.95岁。最常见的症状是呼吸急促(85%)和咳嗽(73%)。高血压(65%)和糖尿病(55%)是我们患者中最常见的合并症。在我们的多变量回归分析中,男性、就诊时恶心和食欲不振与CP治疗后氧合改善有关。总生存时间、阻塞性气道疾病史、在家使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂与生存率降低有关,而西班牙裔种族在CP治疗后显示出生存率较低的趋势。我们的研究突出了市中心安全网医院患者群体可能从CP治疗中受益的几个重要特征。

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本文引用的文献

1
Association of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers with risk of mortality, severity or SARS-CoV-2 test positivity in COVID-19 patients: meta-analysis.血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂与 COVID-19 患者死亡率、严重程度或 SARS-CoV-2 检测阳性率的关系:荟萃分析。
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N Engl J Med. 2021 Mar 18;384(11):1015-1027. doi: 10.1056/NEJMoa2031893. Epub 2021 Jan 13.
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Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial.COVID-19 患者入院后停用与继续使用血管紧张素转换酶抑制剂和血管紧张素 II 受体阻滞剂对存活日数和出院日数的影响:一项随机临床试验。
JAMA. 2021 Jan 19;325(3):254-264. doi: 10.1001/jama.2020.25864.
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Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults.早期高滴度血浆疗法预防老年人重症 COVID-19。
N Engl J Med. 2021 Feb 18;384(7):610-618. doi: 10.1056/NEJMoa2033700. Epub 2021 Jan 6.
6
The "sex gap" in COVID-19 trials: a scoping review.新冠病毒疾病试验中的“性别差异”:一项范围综述
EClinicalMedicine. 2020 Dec;29:100652. doi: 10.1016/j.eclinm.2020.100652. Epub 2020 Nov 30.
7
A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia.新冠肺炎重症肺炎患者恢复期血浆的随机临床试验。
N Engl J Med. 2021 Feb 18;384(7):619-629. doi: 10.1056/NEJMoa2031304. Epub 2020 Nov 24.
8
Asthma in COVID-19 patients: An extra chain fitting around the neck?新冠病毒感染患者的哮喘:脖子上的又一条锁链?
Respir Med. 2020 Dec;175:106205. doi: 10.1016/j.rmed.2020.106205. Epub 2020 Nov 11.
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Euro Surveill. 2020 Nov;25(45). doi: 10.2807/1560-7917.ES.2020.25.45.2001754.
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