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2021 年 2 月至 3 月,在迪拜一家三级保健医院,使用恢复期血浆治疗处于 COVID-19 感染早期阶段的孕妇:病例系列研究。

Use of convalescent plasma in pregnant women with early stage COVID-19 infection in a tertiary care hospital in Dubai, February to March 2021: a case series study.

机构信息

Latifa Women and Children Hospital, Dubai Health Authority, Dubai, United Arab Emirates.

College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai Health Care City, Dubai, United Arab Emirates.

出版信息

BMC Pregnancy Childbirth. 2022 Sep 25;22(1):730. doi: 10.1186/s12884-022-05043-w.

DOI:10.1186/s12884-022-05043-w
PMID:36155102
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9509581/
Abstract

BACKGROUND

The use of COVID-19 convalescent plasma (CCP) for the treatment of SARS-CoV-2 infection in pregnancy is intriguing in view of its safety profile in pregnancy and historical precedence of the use of plasma for other viral illnesses. This study aimed to evaluate the use of CCP in pregnant women with early COVID-19 infection.

METHODS

This is a retrospective case series study. We have included seven pregnant women admitted with early COVID-19 infection to a tertiary care hospital, Latifa Maternity Hospital in Dubai, United Arab Emirates between 12 February and 04 March 2021 and who consented to receive COVID-19 convalescent plasma as part of their treatment plan. Main outcomes measured were clinical and radiological features, laboratory tests, WHO clinical progression scale pre and post treatment, and maternal, fetal outcomes. COVID-19 clinical severity was classified according to the NIH guidelines for criteria of SARS-CoV-2. For the radiological features, a modified chest X-ray scoring system was used where each lung was divided into 6 zones (3 on each side upper, middle, and lower). Opacities were classified into reticular, ground glass, patchy and dense consolidations patterns.

RESULTS

Seven pregnant women with early COVID-19 were enrolled in this study, their mean age was 28 years (SD 3.6). Four had comorbidities: 2 with diabetes, 1 with asthma, and 1 was obese. Five patients were admitted with a WHO clinical progression score of 4 (hospitalized; with no oxygen therapy) and 2 with a score of 5 (hospitalized; oxygen by mask/nasal prongs). Upon follow up on day 10, 6 patients had a WHO score of 1 or 2 (asymptomatic/mild symptoms) indicating clinical recovery. Adverse reactions were reported in 2 patients, one reported a mild skin rash, and another developed transfusion related circulatory overload. All patients were discharged alive.

CONCLUSION

CCP seems to be a promising modality of treating COVID-19 infected pregnant women. However, further studies are needed to ascertain the efficacy of CCP in preventing progressive disease in the management of COVID-19 infection in pregnant women.

摘要

背景

鉴于 COVID-19 恢复期血浆(CCP)在妊娠期间的安全性,以及其在治疗其他病毒性疾病时使用血浆的历史先例,将 CCP 用于 SARS-CoV-2 感染的妊娠治疗具有一定吸引力。本研究旨在评估 CCP 在早期 COVID-19 感染孕妇中的应用。

方法

这是一项回顾性病例系列研究。我们纳入了 2021 年 2 月 12 日至 3 月 4 日期间在阿拉伯联合酋长国迪拜拉蒂法妇产医院因早期 COVID-19 感染住院且同意接受 COVID-19 恢复期血浆治疗的 7 名孕妇。主要观察指标为临床和影像学特征、实验室检查、治疗前后世界卫生组织临床进展量表(WHO 临床进展量表)以及母婴结局。根据 NIH 指南,COVID-19 临床严重程度分为 SARS-CoV-2 标准。对于影像学特征,使用改良的胸部 X 线评分系统,每个肺分为 6 个区(每侧上、中、下各 3 个区)。将不透明性分为网状、磨玻璃、斑片状和致密性实变。

结果

本研究纳入了 7 名早期 COVID-19 孕妇,平均年龄为 28 岁(标准差 3.6)。4 名患者合并有基础疾病:2 例糖尿病、1 例哮喘、1 例肥胖。5 例患者因 WHO 临床进展评分 4 分(住院;无吸氧治疗)入院,2 例患者因评分 5 分(住院;面罩/鼻插吸氧)入院。第 10 天随访时,6 名患者的 WHO 评分降至 1 分或 2 分(无症状/轻度症状),表明临床康复。2 名患者出现不良反应,1 例报告轻度皮疹,另 1 例发生输血相关循环超负荷。所有患者均存活出院。

结论

CCP 似乎是治疗 COVID-19 感染孕妇的一种很有前景的方法。然而,还需要进一步研究以确定 CCP 在预防 COVID-19 感染孕妇疾病进展方面的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/6f8fca517af8/12884_2022_5043_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/391340733676/12884_2022_5043_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/dbeecac0c615/12884_2022_5043_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/6f8fca517af8/12884_2022_5043_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/391340733676/12884_2022_5043_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/85a838637aa5/12884_2022_5043_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/5fe511918083/12884_2022_5043_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/6b502415b5fc/12884_2022_5043_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/dbeecac0c615/12884_2022_5043_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ec/9509581/6f8fca517af8/12884_2022_5043_Fig8_HTML.jpg

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