Department of Pediatric Nutrition and Metabolism Clinics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; Chief of Pediatric Nutrition and Metabolism Department, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Pediatric Nutrition and Metabolism Clinics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; Department of Pediatrics, Postdoctorate Fellow of Pediatric Nutrition and Metabolism, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Transfus Apher Sci. 2022 Aug;61(4):103418. doi: 10.1016/j.transci.2022.103418. Epub 2022 Mar 12.
To determine whether convalescent angiotensin (1-7) peptide replacement therapy with plasma (peptide plasma) transfusion can be beneficial in the treatment of critically ill patients with severe coronavirus 2 (SARS-CoV-2) infection.
Case series of 9 critically ill patients with laboratory-confirmed COVID-19 who met the following criteria: severe pneumonia with rapid progression and continuously high viral load despite antiviral treatment. Peptide plasma: Plasma with angiotensin (1-7) content 8-10 times higher than healthy plasma donors was obtained from suitable donors. Peptide plasma transfusion was applied to 9 patients whose clinical status and/or laboratory profile deteriorated and who needed intensive care for 2 days.
In our COVID-19 cases, favipiravir, low molecular weight heparin treatment, which is included in the treatment protocol of the ministry of health, was started. Nine patients with oxygen saturation of 93% and below despite nasal oxygen support, whose clinical and/or laboratory deteriorated, were identified. The youngest of the cases was 36 years old, and the oldest patient was 85 years old. 6 of the 9 cases had male gender. 3 cases had been smoking for more than 10 years. 4 cases had at least one chronic disease. In all of our cases, SARS CoV2 lung involvement was bilateral and peptide plasma therapy was administered in cases when oxygen saturation was 93% and below despite nasal oxygen support of 5 liters/minute and above, and intensive care was required. Although it was not reflected in the laboratory parameters in the early period, 8 patients whose saturations improved with treatment were discharged without the need for intensive care. However, a similar response was not obtained in one case. Oxygen requirement increased gradually and, he died in intensive care process. An increase of the platelet count was observed in all cases following the peptide plasma treatment.
In this preliminary case series of 9 critically ill patients with COVID-19, administration of plasma containing angiotensin (1-7) was followed by improvement in their clinical status. The limited sample size and study design preclude a definitive statement about the potential effectiveness of this treatment, and these observations require evaluation in clinical trials.
确定恢复期血管紧张素（1-7）肽替代疗法是否有益于治疗严重冠状病毒 2（SARS-CoV-2）感染的危重症患者。
对 9 例经实验室确诊为 COVID-19 的危重症患者进行病例系列研究，这些患者符合以下标准：严重肺炎，尽管进行抗病毒治疗，但病毒载量仍迅速升高。肽血浆：从合适的供体中获得血管紧张素（1-7）含量比健康血浆供体高 8-10 倍的血浆。当临床状态和/或实验室特征恶化且需要重症监护 2 天的 9 例患者应用肽血浆输注。
在我们的 COVID-19 病例中，开始使用法匹拉韦治疗，低分子量肝素治疗已纳入卫生部的治疗方案。确定了 9 例尽管接受鼻氧支持但氧饱和度仍低于 93%且临床和/或实验室恶化的患者。年龄最小的患者为 36 岁，最年长的患者为 85 岁。9 例患者中 6 例为男性。3 例患者有 10 年以上吸烟史。4 例患者至少有一种慢性病。在我们所有的病例中，SARS CoV2 肺部受累均为双侧，当氧饱和度低于 93%，但接受 5 升/分钟以上的鼻氧支持且需要重症监护时，给予肽血浆治疗。尽管早期实验室参数未反映出来，但 8 例患者的治疗后饱和度有所改善，无需重症监护即可出院。然而，一例患者没有得到类似的反应。氧需求逐渐增加，他在重症监护过程中死亡。所有病例在接受肽血浆治疗后血小板计数均增加。
在这项 COVID-19 危重症患者的初步病例系列研究中，给予含血管紧张素（1-7）的血浆后，其临床状态得到改善。样本量有限且研究设计不允许对该治疗的潜在有效性作出明确声明，这些观察结果需要临床试验评估。
