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恢复期血浆疗法对中重度 COVID-19 患者死亡率的影响。

Effect of convalescent plasma therapy on mortality in moderate-to-severely Ill COVID-19 patients.

机构信息

Department of Pathology, University College of Medical Sciences and GTB Hospital, Delhi, India.

Department of Pathology, Incharge, Blood Bank and Regional Transfusion Centre, University College of Medical Sciences and GTB Hospital, Delhi, India.

出版信息

Transfus Apher Sci. 2022 Dec;61(6):103455. doi: 10.1016/j.transci.2022.103455. Epub 2022 May 11.

Abstract

INTRODUCTION

The role of plasma therapy in the management of the COVID-19, pandemic has been speculated. However, in view of the varied response regarding its effectiveness from various multicenter studies, there is a need to conduct more single center population-specific studies. We, thus, aimed to assess the role of convalescent plasma therapy in COVID-19 patient management in a single -center.

METHODS

This retrospective study was conducted using records of all COVID-19 patients who received plasma therapy over a period of 6 months in a dedicated COVID-19 hospital in Delhi. Information pertaining to transfusion, disease severity, associated comorbidities, the treatment given and patient outcome were recorded. Data was analyzed using SPSSv23.

RESULTS

Of the141 patients who received plasma therapy, 62% were discharged after treatment. Mortality was found to be significantly higher in patients > 60 years of age (p < 0.001), those with severe COVID-19 infection (p < 0.05) and pre-existing renal disease (p < 0.05). The admission-transfusion interval was significantly correlated to mortality and was a sensitive parameter for predicting outcome at cut off value of < 5 days (p < 0.001). There was no significant association of mortality with patient blood group, plasma antibody levels or donor hemoglobin levels.

CONCLUSIONS

We report improvement and recovery in a large number of patients who received convalescent plasma within the first 5 days of hospitalization with moderate to severe disease. Further research to compare dosage and administration protocols to delineate role of CCP in survival of COVID-19 patients is needed before it is prematurely shelved.

摘要

简介

血浆疗法在 COVID-19 大流行管理中的作用一直备受推测。然而,鉴于来自各种多中心研究的关于其有效性的不同反应,有必要进行更多的单中心人群特定研究。因此,我们旨在评估单中心中恢复期血浆疗法在 COVID-19 患者管理中的作用。

方法

这项回顾性研究使用了在德里的一家专门 COVID-19 医院接受血浆治疗的所有 COVID-19 患者的记录。记录了与输血、疾病严重程度、相关合并症、所给予的治疗和患者结局相关的信息。使用 SPSSv23 对数据进行分析。

结果

在接受血浆治疗的 141 名患者中,有 62%在治疗后出院。发现年龄>60 岁的患者(p<0.001)、患有严重 COVID-19 感染的患者(p<0.05)和存在预先存在的肾脏疾病的患者(p<0.05)的死亡率明显更高。入院-输血间隔与死亡率显著相关,并且是预测结局的敏感参数,截断值<5 天(p<0.001)。死亡率与患者血型、血浆抗体水平或供体血红蛋白水平无显著关联。

结论

我们报告了在中度至重度疾病住院的前 5 天内接受恢复期血浆的大量患者的改善和康复。在过早搁置之前,需要进一步研究比较剂量和管理方案,以确定 CCP 在 COVID-19 患者生存中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/612f/9090870/6242f70f952e/fx1_lrg.jpg

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