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肥胖的重症 COVID-19 青少年的恢复期血浆治疗:两例报告。

Convalescent plasma therapy in obese severe COVID-19 adolescents: Two cases report.

作者信息

Cesilia Citra, Ridar Elmi, Suryawan Nur, Nataprawira Heda Melinda

机构信息

Department of Child Health, Faculty of Medicine, Riau University - Arifin Achmad General Hospital, Pekanbaru, Indonesia.

Department of Child Health, Faculty of Medicine, Padjajaran University - Dr. Hasan Sadikin, Bandung, Indonesia.

出版信息

Ann Med Surg (Lond). 2021 Dec;72:103084. doi: 10.1016/j.amsu.2021.103084. Epub 2021 Nov 18.

Abstract

BACKGROUND

In Indonesia, 175 cases resulted in death in children from March to December 2020. Studies regarding Convalescent Plasma Therapy's (CPT) safety and efficacy in children are scarce. Our case report was the first to write CPT in Indonesian children.

CASE PRESENTATION

In our case, two obese children with progressive shortness of breath, worsening cough, and high fever, the findings met severe COVID-19 criteria. We performed CPT for these patients and the patient's condition was improved and able to be discharged.

DISCUSSION

Severe COVID-19 with or without comorbid was the indication of CPT which had been approved by the U.S. FDA and Indonesian Pediatrics Society. The key factors associated with CPT efficacy were the donor's titer antibody, the treatment time point, and the patient's comorbidities. The clinical impact showed an improvement by the combination therapy of CPT and remdesivir.

CONCLUSION

We noted that CPT might be well tolerated, could improve the clinical impact of severe COVID-19 in adolescents, and have no adverse events as well. CPT for severe COVID-19 cases in children had the potential to be developed in studies with better designs and stronger levels of evidence.

摘要

背景

在印度尼西亚,2020年3月至12月期间有175例儿童死亡病例。关于恢复期血浆疗法(CPT)在儿童中的安全性和有效性的研究很少。我们的病例报告是首次在印度尼西亚儿童中撰写关于CPT的内容。

病例介绍

在我们的病例中,两名肥胖儿童出现进行性呼吸急促、咳嗽加重和高烧,检查结果符合重症COVID-19标准。我们对这些患者进行了CPT治疗,患者病情得到改善并得以出院。

讨论

伴有或不伴有合并症的重症COVID-19是CPT的适应症,这已得到美国食品药品监督管理局(FDA)和印度尼西亚儿科学会的批准。与CPT疗效相关的关键因素是供体的抗体滴度、治疗时间点和患者的合并症。临床影响显示CPT与瑞德西韦联合治疗有改善效果。

结论

我们注意到CPT可能耐受性良好,可以改善青少年重症COVID-19的临床影响,并且也没有不良事件。针对儿童重症COVID-19病例的CPT有潜力在设计更好、证据水平更强的研究中得到发展。

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