Peppers Brian P, Shmookler Aaron, Stanley Johnathan, Giblin Sutton Lisa, Perrotta Peter L, Kieffer Theodore, Skoner David, Mahady Stacey, Lewandrowski Callum, Damron Heath, Horspool Alexander, Sakhjua Ankit, McCarthy Paul, Hostoffer Robert W
WVU Medicine Children's Hospital, Section of Allergy and Immunology, Morgantown, WV, USA.
Department of Pathology, Anatomy and Laboratory Sciences, West Virginia University School of Medicine, Morgantown, WV, USA.
Allergy Rhinol (Providence). 2022 Jun 30;13:21526575221110488. doi: 10.1177/21526575221110488. eCollection 2022 Jan-Dec.
The rapid spread of SARS-CoV-2, the virus that is responsible for causing COVID-19, has presented the medical community with another example of when convalescent plasma (CP) is still used today. The ability to standardize CP at the onset of a pandemic is unlikely to exist in a reliable and uniformly reproducible way. We hypothesized that CP of unknown strength given in a serial manner will promote health and reduce mortality in those inflicted with COVID-19.
Participants were given up to 8 CP-units depending on their condition upon entry into the study and their response.
102 out of 117 participants were given CP. The earlier a participant received CP corelated with survival (p = 0.0004). The number of CP-units given, throughout all the clinical severities, was not significant with outcomes, p = 0.3947. A higher number of CP-units given to the severe/critical participants (without biological immunosuppressants or restrictive lung disease) did correlate with survival p = 0.0116 (2.8 vs. 2 units). Lower platelets on admission corelated with mortality. Platelet levels increase correlated with CP infusions p < 0.0001.
This study supports the serial use of CP of unknown strength based on clinical response for those infected with COVID-19. The use of 3-4 units of CP was found to be statistically significant for survival for severe and critical participants without restrictive lung disease and chronic biological immunosuppression. Increased platelet levels after CP infusions supports that CP is promoting overall health regardless of outcomes.
导致新冠肺炎的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）迅速传播，为医学界提供了当今仍在使用恢复期血浆（CP）的另一个例子。在大流行开始时以可靠且一致可重复的方式标准化CP的能力不太可能存在。我们假设，以系列方式给予强度未知的CP将促进感染新冠肺炎患者的健康并降低死亡率。
根据参与者进入研究时的病情及其反应，给予他们最多8个CP单位。
117名参与者中有102名接受了CP。参与者接受CP的时间越早，与生存率相关（p = 0.0004）。在所有临床严重程度中，给予的CP单位数量与结果无关，p = 0.3947。给予重症/危重症参与者（无生物免疫抑制剂或限制性肺病）的CP单位数量较多确实与生存率相关，p = 0.0116（2.8个单位对2个单位）。入院时血小板水平较低与死亡率相关。血小板水平升高与CP输注相关，p < 0.0001。
本研究支持根据临床反应对感染新冠肺炎的患者系列使用强度未知的CP。对于没有限制性肺病和慢性生物免疫抑制的重症和危重症参与者，发现使用3 - 4个单位的CP对生存率具有统计学意义。CP输注后血小板水平升高支持CP无论结果如何都在促进整体健康。
