Department of Transfusion Medicine & Transplant Immunology, Indraprastha Apollo Hospitals, Sarita Vihar, Mathura Road, New Delhi 110076, India.
Department of Medical Services, Indraprastha Apollo Hospitals, Sarita Vihar, Mathura Road, New Delhi 110076, India.
Transfus Apher Sci. 2022 Dec;61(6):103497. doi: 10.1016/j.transci.2022.103497. Epub 2022 Jul 1.
Various therapies have been tried for Covid disease including the use of antivirals, steroids, monoclonal antibodies and convalescent plasma.
The study was conducted on convalescent plasma transfused ICU patients. Part A of the study involves clinical outcomes based on gender, age, comorbidities, blood group,and the average length of stay. Part B investigates clinical outcomes in patients transfused with convalescent plasma before and after the November 2021 guidelines. Part C of the study includes patients in cytokine storm and the efficacy of tocilizumab in these patients.
Out of the 326 ICU patients transfused with convalescent plasma the overall mortality was 152 (53.3 %). On comparing blood groups and clinical outcomes, a clinically significant result was found. A clinically significant association was also seen on comparing the clinical outcome of 18-50 years and 61-70 years age group and in female gender patients. The average number of ICU days had a positive impact on the overall patient survival. Out of the patients in 'cytokine storm' (n = 109), on day 20, the survival percentage in the non-Tocilizumab group showed a downward trend throughout. However, in the Tocilizumab group, the survival percentage remained stable throughout till around day 50.
Amongst the convalescent plasma transfused ICU patients, females, having blood group B, and an average length of stay of fewer than 20 days had a better chance of survival. The patients given tocilizumab and convalescent plasma had a better chance of survival compared to tocilizumab alone.
针对新冠疾病,已经尝试了各种治疗方法,包括使用抗病毒药物、类固醇、单克隆抗体和恢复期血浆。
本研究针对输注恢复期血浆的 ICU 患者进行。研究分为三个部分:A 部分基于性别、年龄、合并症、血型和平均住院时间,评估临床结局;B 部分调查了 2021 年 11 月指南更新前后输注恢复期血浆患者的临床结局;C 部分研究了细胞因子风暴患者以及托珠单抗在这些患者中的疗效。
在 326 例输注恢复期血浆的 ICU 患者中,总死亡率为 152 例(53.3%)。比较血型和临床结局时,发现了有临床意义的结果。比较 18-50 岁和 61-70 岁年龄组以及女性患者的临床结局时,也存在显著的临床关联。ICU 天数的平均值对整体患者生存率有积极影响。在“细胞因子风暴”患者(n=109)中,第 20 天,非托珠单抗组的生存率呈下降趋势,而托珠单抗组的生存率则保持稳定,直至第 50 天左右。
在输注恢复期血浆的 ICU 患者中,女性、血型为 B 型以及平均住院时间少于 20 天的患者,生存率更高。与单独使用托珠单抗相比,使用托珠单抗和恢复期血浆的患者生存率更高。