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康復期血漿治療對印尼 8 例非插管 COVID-19 患者的療效:病例系列研究。

Effectiveness of convalescent plasma therapy in eight non-intubated coronavirus disease 2019 patients in Indonesia: a case series.

机构信息

Faculty of Medicine, Maranatha Christian University, Suria Sumantri 65, Bandung, West Java, 40164, Indonesia.

Primaya Hospital, Tangerang, Indonesia.

出版信息

J Med Case Rep. 2021 Nov 23;15(1):564. doi: 10.1186/s13256-021-03059-y.

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2, the cause of coronavirus disease 2019, has become a global pandemic. Currently, there is no definitive treatment for coronavirus disease 2019. Convalescent plasma therapy has become a potential specific curative method, while vaccines as protection modalities require further work.

CASE PRESENTATION

Eight non-intubated Indonesian patients, ages ranging from 40 to 74 years old, with coronavirus disease 2019 confirmed by viral Ribonucleid Acid (RNA) real-time polymerase chain reaction tests were included. Four patients were administered two doses of 200 mL convalescent plasma, and the other four patients were administered one dose of convalescent plasma with an antibody titer of 1:320, within the first 14 days since symptoms occurred. The median times from illness onset to convalescent plasma therapy and from the first day of hospital admission to convalescent plasma therapy were 13 and 6.5 days, respectively. All patients showed improvements in clinical symptoms, laboratory parameters, thorax imaging, negative conversion of polymerase chain reaction results, and decreased oxygen supplementation within 1 week after convalescent plasma therapy. Patients with two convalescent plasma doses tended to have faster recovery than those with one convalescent plasma dose. No severe adverse effects were observed in any patient.

CONCLUSION

This is the first case series in Indonesia showing that convalescent plasma therapy is safe and well tolerated and that early convalescent plasma therapy before the patient is intubated could potentially prevent disease progression, increase the recovery rate, and shorten the inpatient time of stay.

摘要

背景

导致 2019 冠状病毒病的严重急性呼吸综合征冠状病毒 2 已在全球范围内引发大流行。目前,针对 2019 冠状病毒病尚无明确的治疗方法。恢复期血浆疗法已成为一种有潜力的特效治疗方法,而疫苗作为保护手段还需要进一步研究。

病例介绍

8 例非插管的印尼患者,年龄 40 至 74 岁,经病毒核糖核酸(RNA)实时聚合酶链反应检测确诊为 2019 冠状病毒病。4 例患者接受了 200ml 恢复期血浆的 2 个剂量治疗,另 4 例患者接受了 1 个剂量的恢复期血浆治疗,抗体滴度为 1:320,治疗时间均在症状出现后 14 天内。从发病到接受恢复期血浆治疗的中位数时间和从入院到接受恢复期血浆治疗的中位数时间分别为 13 天和 6.5 天。所有患者在接受恢复期血浆治疗后 1 周内临床症状、实验室参数、胸部影像学、聚合酶链反应结果转阴和减少吸氧均有改善。接受 2 个剂量恢复期血浆的患者比接受 1 个剂量恢复期血浆的患者恢复得更快。所有患者均未观察到严重不良反应。

结论

这是印度尼西亚首例关于恢复期血浆治疗安全且耐受良好的病例系列研究,提示早期在患者插管前接受恢复期血浆治疗可能有助于防止疾病进展、提高恢复率并缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0207/8609719/063a6e34e17b/13256_2021_3059_Fig1_HTML.jpg

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