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自体活化富血小板血浆(aaPRP)治疗重症2019冠状病毒病(COVID-19)患者的I/II期临床试验

Phase I/II Clinical Trial of Autologous Activated Platelet-Rich Plasma (aaPRP) in the Treatment of Severe Coronavirus Disease 2019 (COVID-19) Patients.

作者信息

Karina Karina, Rosliana Iis, Rosadi Imam, Sobariah Siti, Christoffel Louis Martin, Novariani Rita, Rosidah Siti, Fatkhurohman Novy, Hertati Yuli, Puspitaningrum Nurlaela, Subroto Wismo Reja, Afini Irsyah, Ernanda Difky

机构信息

HayandraLab, Yayasan Hayandra Peduli, Jakarta, Indonesia.

Klinik Hayandra, Yayasan Hayandra Peduli, Jakarta, Indonesia.

出版信息

Int J Inflam. 2021 Jul 7;2021:5531873. doi: 10.1155/2021/5531873. eCollection 2021.

Abstract

BACKGROUND

The outbreak of Coronavirus Disease 2019 (COVID-19) has been increasing rapidly. This disease causes an increase in proinflammatory cytokine production that leads to cytokine storm or cytokine release syndrome (CRS). Autologous activated platelet-rich plasma (aaPRP) contains various types of growth factors and anti-inflammatory cytokines that may have the potential to suppress CRS. This study of phase I/II trial was aimed to evaluate the safety and efficacy of aaPRP to treat severe COVID-19 patients.

METHODS

A total of 10 severe COVID-19 patients from Koja Regional Public Hospital (Koja RPH) were admitted to the intensive care unit (ICU). All patients received aaPRP administration three times. Primary outcomes involving the duration of hospitalization, oxygen needs, time of recovery, and mortality were observed. Secondary outcomes involving C-reactive protein (CRP), neutrophil, lymphocyte, and lymphocyte-to-CRP (LCR) and neutrophil-lymphocyte ratio (NLR) were analyzed.

RESULTS

All patients were transferred to the ICU with a median duration of 9 days. All patients received oxygen at enrollment and nine of ten patients recovered from the ICU and transferred to the ward room. There was one patient who passed away in the ICU due to heart failure. The results of secondary outcomes showed that CRP value and lymphocytes counts were significantly decreased while neutrophils, LCR, and NLR were slightly increased after aaPRP administration.

CONCLUSIONS

Our results of the phase I/II trial demonstrated that the use of aaPRP in severe COVID-19 patients was safe and not associated with serious adverse events, which showed that aaPRP was a promising adjunctive therapy for severe COVID-19 patients.

摘要

背景

2019年冠状病毒病(COVID-19)疫情一直在迅速蔓延。这种疾病会导致促炎细胞因子产生增加,进而引发细胞因子风暴或细胞因子释放综合征(CRS)。自体活化富血小板血浆(aaPRP)含有多种生长因子和抗炎细胞因子,可能具有抑制CRS的潜力。这项I/II期试验研究旨在评估aaPRP治疗重症COVID-19患者的安全性和有效性。

方法

共有10名来自科贾地区公立医院(Koja RPH)的重症COVID-19患者被收治入重症监护病房(ICU)。所有患者均接受3次aaPRP给药。观察的主要结局包括住院时间、氧气需求、康复时间和死亡率。分析的次要结局包括C反应蛋白(CRP)、中性粒细胞、淋巴细胞以及淋巴细胞与CRP之比(LCR)和中性粒细胞与淋巴细胞之比(NLR)。

结果

所有患者被转入ICU,中位时长为9天。所有患者入院时均接受吸氧,10名患者中有9名从ICU康复并转入病房。有1名患者在ICU因心力衰竭去世。次要结局结果显示,aaPRP给药后,CRP值和淋巴细胞计数显著下降,而中性粒细胞、LCR和NLR略有上升。

结论

我们I/II期试验的结果表明,在重症COVID-19患者中使用aaPRP是安全的,且未发生严重不良事件,这表明aaPRP是一种有前景的重症COVID-19患者辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6472/8285191/67c4d86881e1/IJI2021-5531873.001.jpg

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