Fitriah Munawaroh, Putri Aditea Etnawati, Semedi Bambang Pujo, Atika Atika, Tambunan Betty Agustina
Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Open Access Emerg Med. 2023 Apr 24;15:109-118. doi: 10.2147/OAEM.S405555. eCollection 2023.
Convalescent plasma therapy (CPT) is an alternative therapy for managing COVID-19, but its use is still controversial.
Analyzing the effectiveness of CPT in modulating immune responses based on SARS-COV-2 anti-spike protein receptor-binding domain (s-RBD) IgG, inflammatory cytokines (IL-6 and IL-4), and mortality in severe-critical COVID-19 patients.
This study was an observational analytical with a prospective cohort design. The number of participants was 39 patients from June to December 2020. The participants received CPT and was tested for blood analysis such as IL-4, IL-6 and s-RBD IgG. The data were taken a day before CPT, 1st day, 2nd day, and 7th day after CPT. The analysis included Friedman, Pearson correlation, and Mann-Whitney test which is significant if <0.05.
The value of participant's s-RBD IgG before CPT was 91.49 (0.43-3074.73) AU/mL and the 7th day post-CPT, s-RBD IgG value of 1169.79 (6.48-5577.91) AU/mL ( <0.001). The IL-4 value before CPT was 1.78 (0.85-5.21) ng/mL and the 7th day post-CPT, IL-4 value of 1.97 (0.87-120.30) ng/mL ( = 0.401). The condition was also found in IL-6 value, in which the IL-4 value participant before CPT was 109.61 (0.73-4701.63) ng/mL and the 7th day post-CPT, IL-6 value of 1.97 (0.87-120.30) ng/mL ( = 0.401). No significant correlation found between increased s-RBD IgG level with increased IL-4 and decreased IL-6 before and after CPT in severe-critical COVID-19 patients ( >0.05). No significant correlation was also found between increased s-RBD IgG levels, IL-4 too, and decreased IL-6 after CPT therapy between deceased and alive patients, both in 1st, 2nd, and 7th days ( >0.05).
No correlation between the increase in s-RBD IgG levels and changes in IL-4 and IL-6 levels. Changes in s-RBD IgG, IL-4, and IL-6 levels are not associated with mortality in severe-critical COVID-19 degree post CPT recipients.
恢复期血浆疗法（CPT）是治疗新型冠状病毒肺炎（COVID-19）的一种替代疗法，但其应用仍存在争议。
基于严重危重型COVID-19患者的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）抗刺突蛋白受体结合域（s-RBD）免疫球蛋白G（IgG）、炎性细胞因子（白细胞介素6（IL-6）和白细胞介素4（IL-4））以及死亡率，分析CPT在调节免疫反应方面的有效性。
本研究是一项采用前瞻性队列设计的观察性分析研究。2020年6月至12月共有39名参与者。参与者接受了CPT治疗，并进行了血液分析检测，如IL-4、IL-6和s-RBD IgG检测。数据采集时间为CPT治疗前一天、治疗后第1天、第2天和第7天。分析方法包括弗里德曼检验、皮尔逊相关性检验和曼-惠特尼检验，若P<0.05则具有统计学意义。
CPT治疗前参与者的s-RBD IgG值为91.49（0.43 - 3074.73）AU/mL，CPT治疗后第7天，s-RBD IgG值为1169.79（6.48 - 5577.91）AU/mL（P<0.001）。CPT治疗前IL-4值为1.78（0.85 - 5.21）ng/mL，CPT治疗后第7天，IL-4值为1.97（0.87 - 120.30）ng/mL（P = 0.401）。IL-6值也有类似情况，CPT治疗前参与者的IL-6值为109.61（0.73 - 4701.63）ng/mL，CPT治疗后第7天，IL-6值为1.97（0.87 - 120.30）ng/mL（P = 0.401）。在严重危重型COVID-19患者中，CPT治疗前后s-RBD IgG水平升高与IL-4升高和IL-6降低之间未发现显著相关性（P>0.05）。在治疗后第1天、第2天和第7天，死亡患者和存活患者之间，s-RBD IgG水平升高、IL-4升高以及IL-6降低之间也未发现显著相关性（P>0.05）。
s-RBD IgG水平升高与IL-4和IL-6水平变化之间无相关性。CPT治疗后，s-RBD IgG、IL-4和IL-6水平的变化与严重危重型COVID-19患者的死亡率无关。
