Department of Laboratory Medicine, Children's National Hospital, District of Columbia, Washington, USA.
Departments of Pathology and Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Transfusion. 2023 May;63(5):918-924. doi: 10.1111/trf.17318. Epub 2023 Mar 30.
Convalescent COVID-19 plasma (CCP) was developed and used worldwide as a treatment option by supplying passive immunity. Adult studies suggest administering high-titer CCP early in the disease course of patients who are expected to be antibody-negative; however, pediatric experience is limited. We created a multi-institutional registry to characterize pediatric patients (<18 years) who received CCP and to assess the safety of this intervention.
A REDCap survey was distributed. The registry collected de-identified data including demographic information (age, gender, and underlying conditions), COVID-19 disease features and concurrent treatments, CCP transfusion and safety events, and therapy response.
Ninety-five children received CCP: 90 inpatients and 5 outpatients, with a median age of 10.2 years (range 0-17.9). They were predominantly Latino/Hispanic and White. The most frequent underlying medical conditions were chronic respiratory disease, immunosuppression, obesity, and genetic syndromes. CCP was primarily given as a treatment (95%) rather than prophylaxis (5%). Median total plasma dose administered and transfusion rates were 5.0 ml/kg and 2.6 ml/kg/h, respectively. The transfusions were well-tolerated, with 3 in 115 transfusions reporting mild reactions. No serious adverse events were reported. Severity scores decreased significantly 7 days after CCP transfusion or at discharge. Eighty-five patients (94.4%) survived to hospital discharge. All five outpatients survived to 60 days.
CCP was found to be safe and well-tolerated in children. CCP was frequently given concurrently with other COVID-19-directed treatments with improvement in clinical severity scores ≥7 days after CCP, but efficacy could not be evaluated in this study.
恢复期新冠病毒（COVID-19）血浆（CCP）通过提供被动免疫在全球范围内被开发和用作治疗选择。成人研究表明，对于预计抗体阴性的患者，应在疾病早期给予高滴度 CCP；然而，儿科经验有限。我们创建了一个多机构注册中心，以描述接受 CCP 的儿科患者（<18 岁）的特征，并评估该干预措施的安全性。
发布了一份 REDCap 调查。该注册中心收集了匿名数据，包括人口统计学信息（年龄、性别和基础疾病）、COVID-19 疾病特征和同时进行的治疗、CCP 输血和安全事件以及治疗反应。
95 名儿童接受了 CCP：90 名住院患者和 5 名门诊患者，中位年龄为 10.2 岁（范围 0-17.9）。他们主要是拉丁裔/西班牙裔和白人。最常见的基础疾病是慢性呼吸系统疾病、免疫抑制、肥胖和遗传综合征。CCP 主要用于治疗（95%）而不是预防（5%）。给予的总血浆剂量中位数和输血率分别为 5.0ml/kg 和 2.6ml/kg/h。输血耐受性良好，115 次输血中有 3 次报告轻微反应。未报告严重不良事件。CCP 输血或出院后 7 天，严重程度评分显著下降。85 名患者（94.4%）存活至出院。所有 5 名门诊患者均存活至 60 天。
CCP 在儿童中被发现是安全且耐受良好的。CCP 经常与其他 COVID-19 靶向治疗同时使用，在 CCP 后 7 天以上，临床严重程度评分改善，但在这项研究中无法评估疗效。
