Aguilar Ricardo, López-Vergès Sandra, Quintana Anarellys, Morris Johanna, Lopez Lineth, Cooke Ana, Quiel Dimas, Buitron Natalie, Pérez Yaseikiry, Lobo Lesbia, Ballesteros Maura, Pitti Yaneth, Diaz Yamilka, Saenz Lisseth, Franco Danilo, Castillo Daniel, Valdespino Elimelec, Blanco Isabel, Romero Emilio, Villarreal Alcibiades, Cubilla-Batista Idalina
Complejo Hospitalario Metropolitano Arnulfo Arias Madrid Caja de Seguro Social Panama Panama.
Hospital Punta Pacífica Pacífica Salud Panama Panama.
Health Sci Rep. 2024 Mar 7;7(3):e1949. doi: 10.1002/hsr2.1949. eCollection 2024 Mar.
At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, transfusion of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) emerged as a potential therapeutic strategy to help patients severely afflicted by COVID-19. The efficacy of CCP has been controversial as it depends on many variables pertaining to the plasma donor and the patient with COVID-19, for example, time of convalescence or symptoms onset. This feasibility and descriptive study aimed to assess the safety of multiple doses of CCP in mechanically ventilated, intubated patients with respiratory failure due to COVID-19.
A cohort of 30 patients all experiencing severe respiratory failure and undergoing invasive mechanical ventilation in an intensive care unit, received up to five doses of 300-600 mL of CCP on alternate days (0, 2, 4, 6, and 8) until extubation, futility, or death.
Nineteen patients received five doses, seven received four, and four received two or three doses. At 28-day follow-up mark, 57% of patients recovered and were sent home, and the long-term mortality rate was 27%. Ten severe adverse events reported in the study were unrelated to CCP transfusion. Independent of the number of transfused doses, most patients had detectable levels of total and neutralizing antibodies in plasma.
This study suggests that transfusion of multiple doses of CCP is safe. This strategy may represent a viable option for future studies, given the potential benefit of CCP transfusions during the early stages of infection in unvaccinated populations and in settings where monoclonal antibodies or antivirals are contraindicated or unavailable.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行初期，输注新型冠状病毒肺炎（COVID-19）康复期血浆（CCP）成为一种潜在的治疗策略，以帮助重症COVID-19患者。CCP的疗效一直存在争议，因为它取决于许多与血浆捐献者和COVID-19患者相关的变量，例如康复时间或症状出现时间。这项可行性和描述性研究旨在评估多剂量CCP在因COVID-19导致呼吸衰竭的机械通气、插管患者中的安全性。
一组30名均患有严重呼吸衰竭并在重症监护病房接受有创机械通气的患者，每隔一天（第0、2、4、6和8天）接受多达五剂300 - 600毫升的CCP，直至拔管、治疗无效或死亡。
19名患者接受了五剂，7名接受了四剂，4名接受了两剂或三剂。在28天的随访标记时，57%的患者康复并出院，长期死亡率为27%。该研究中报告的10起严重不良事件与CCP输注无关。无论输注剂量多少，大多数患者血浆中均可检测到总抗体和中和抗体水平。
本研究表明，输注多剂量CCP是安全的。鉴于在未接种疫苗人群的感染早期以及在单克隆抗体或抗病毒药物禁忌或无法获得的情况下，CCP输注可能具有益处，该策略可能是未来研究的一个可行选择。
