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关于使用恢复期血浆治疗 2019 冠状病毒病免疫功能低下患者的指南。

Guidance on the Use of Convalescent Plasma to Treat Immunocompromised Patients With Coronavirus Disease 2019.

机构信息

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy.

出版信息

Clin Infect Dis. 2023 Jun 8;76(11):2018-2024. doi: 10.1093/cid/ciad066.

Abstract

Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) is a safe and effective treatment for COVID-19 in immunocompromised (IC) patients. IC patients have a higher risk of persistent infection, severe disease, and death from COVID-19. Despite the continued clinical use of CCP to treat IC patients, the optimal dose, frequency/schedule, and duration of CCP treatment has yet to be determined, and related best practices guidelines are lacking. A group of individuals with expertise spanning infectious diseases, virology and transfusion medicine was assembled to render an expert opinion statement pertaining to the use of CCP for IC patients. For optimal effect, CCP should be recently and locally collected to match circulating variant. CCP should be considered for the treatment of IC patients with acute and protracted COVID-19; dosage depends on clinical setting (acute vs protracted COVID-19). CCP containing high-titer severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, retains activity against circulating SARS-CoV-2 variants, which have otherwise rendered monoclonal antibodies ineffective.

摘要

2019 年冠状病毒病(COVID-19)恢复期血浆(CCP)是免疫功能低下(IC)患者 COVID-19 的一种安全有效的治疗方法。IC 患者持续感染、疾病严重程度和 COVID-19 死亡的风险更高。尽管继续将 CCP 用于治疗 IC 患者,但尚未确定 CCP 治疗的最佳剂量、频率/方案和持续时间,并且缺乏相关的最佳实践指南。一组在传染病学、病毒学和输血医学方面具有专业知识的人被召集起来,就 CCP 用于 IC 患者的使用发表专家意见声明。为了达到最佳效果,CCP 应该是最近和本地采集的,以匹配循环变异。应考虑使用 CCP 治疗急性和迁延性 COVID-19 的 IC 患者;剂量取决于临床情况(急性与迁延性 COVID-19)。含有高滴度严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)抗体的 CCP 保留了对循环 SARS-CoV-2 变异的活性,而这些变异已使单克隆抗体无效。

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