Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany.
Department for Transfusion Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany.
Sci Rep. 2022 Nov 9;12(1):19035. doi: 10.1038/s41598-022-23200-1.
Establishing the optimal treatment for COVID-19 patients remains challenging. Specifically, immunocompromised and pre-diseased patients are at high risk for severe disease course and face limited therapeutic options. Convalescent plasma (CP) has been considered as therapeutic approach, but reliable data are lacking, especially for high-risk patients. We performed a retrospective analysis of 55 hospitalized COVID-19 patients from University Hospital Duesseldorf (UKD) at high risk for disease progression, in a substantial proportion due to immunosuppression from cancer, solid organ transplantation, autoimmune disease, dialysis. A matched-pairs analysis (1:4) was performed with 220 patients from the Lean European Open Survey on SARS-CoV-2-infected Patients (LEOSS) who were treated or not treated with CP. Both cohorts had high mortality (UKD 41.8%, LEOSS 34.1%). A matched-pairs analysis showed no significant effect on mortality. CP administration before the formation of pulmonary infiltrates showed the lowest mortality in both cohorts (10%), whereas mortality in the complicated phase was 27.8%. CP administration during the critical phase revealed the highest mortality: UKD 60.9%, LEOSS 48.3%. In our cohort of COVID-19 patients with severe comorbidities CP did not significantly reduce mortality in a retrospective matched-pairs analysis. However, our data supports the concept that a reduction in mortality is achievable by early CP administration.
为 COVID-19 患者确立最佳治疗方案仍然具有挑战性。具体来说，免疫功能低下和患有基础疾病的患者有发生严重疾病过程的高风险，并且面临有限的治疗选择。恢复期血浆（CP）已被认为是一种治疗方法，但缺乏可靠的数据，特别是对于高危患者。我们对来自杜塞尔多夫大学医院（UKD）的 55 名患有 COVID-19 的住院患者进行了回顾性分析，这些患者有进展为疾病的高风险，在很大程度上是由于癌症、实体器官移植、自身免疫性疾病、透析导致的免疫抑制。我们对来自 LEOSS（SARS-CoV-2 感染患者的Lean European Open Survey）的 220 名接受或未接受 CP 治疗的患者进行了配对分析（1:4）。两个队列的死亡率都很高（UKD 为 41.8%，LEOSS 为 34.1%）。配对分析显示死亡率无显著差异。在肺部浸润形成之前进行 CP 治疗的患者在两个队列中的死亡率最低（10%），而在并发症阶段的死亡率为 27.8%。在危急阶段进行 CP 治疗的患者死亡率最高：UKD 为 60.9%，LEOSS 为 48.3%。在我们的 COVID-19 伴有严重合并症的患者队列中，CP 在回顾性配对分析中并未显著降低死亡率。然而，我们的数据支持这样的概念，即通过早期 CP 治疗可以降低死亡率。
