Blood Bank, Shamir Medical Center, Zerifin, Israel.
Internal Medicine Department H, Shamir Medical Center, Zerifin, Israel.
PLoS One. 2022 Jul 19;17(7):e0271036. doi: 10.1371/journal.pone.0271036. eCollection 2022.
Several options to treat hospitalized severe COVID-19 patients have been suggested. The study aimed to describe survival in patients treated with convalescent COVID plasma (CCP) and to identify in-hospital mortality predictors. This prospective cohort study examined data from 112 severe COVID-19 patients hospitalized in the Corona Departments in an acute care hospital who received two units of CCP (at least one of them high-titer). Demographic and medical data was retrieved from the patients' electronic health records (EHR). Possible predictors for in-hospital mortality were analyzed in a univariate analysis and those found to be clinically significant were further analyzed in a multivariable analysis. Median age was 67 years (IQR 55-74) and 66 (58.9%) of them were males. Of them, 20 (17.9%) died in hospital. On multivariable analysis diabetes mellitus (p = 0.004, OR 91.54), mechanical ventilation (p = 0.001, OR 59.07) and lower albumin levels at treatment (p = 0.027, OR 0.74) were significantly associated with increased in-hospital mortality. In our study, in-hospital mortality in patients receiving CCP is similar to that reported for the general population, however certain variables mentioned above were associated with increased in-hospital mortality. In the literature, these variables were also associated with a worse outcome in patients with COVID-19 who did not receive CCP. As evidence points toward a benefit from CCP treatment in immunocompromised patients, we believe the above risk factors can further define COVID-19 patients at increased risk for mortality, enabling the selection of candidates for early treatment in an outpatient setting if possible.
已经提出了几种治疗住院严重 COVID-19 患者的方法。本研究旨在描述接受恢复期 COVID 血浆（CCP）治疗的患者的生存率，并确定住院死亡率的预测因素。这项前瞻性队列研究检查了在一家急性护理医院的 Corona 病房住院的 112 名严重 COVID-19 患者的数据，他们接受了两单位的 CCP（至少有一个是高滴度的）。从患者的电子健康记录（EHR）中检索人口统计学和医学数据。在单变量分析中分析了住院死亡率的可能预测因素，并且在多变量分析中进一步分析了那些具有临床意义的预测因素。中位年龄为 67 岁（IQR 55-74），其中 66 人（58.9%）为男性。其中，20 人（17.9%）在医院死亡。在多变量分析中，糖尿病（p = 0.004，OR 91.54）、机械通气（p = 0.001，OR 59.07）和治疗时白蛋白水平较低（p = 0.027，OR 0.74）与住院死亡率增加显著相关。在我们的研究中，接受 CCP 治疗的患者的住院死亡率与一般人群报告的死亡率相似，但是上述某些变量与住院死亡率增加相关。在文献中，这些变量也与未接受 CCP 治疗的 COVID-19 患者的预后较差相关。由于有证据表明 CCP 治疗对免疫功能低下的患者有益，我们认为上述危险因素可以进一步确定 COVID-19 患者的死亡率增加，从而在可能的情况下在门诊环境中选择候选者进行早期治疗。
