Franchini Massimo, Casadevall Arturo, Dragotakes Quigly, Focosi Daniele
Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, 46100 Mantua, Italy.
Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Life (Basel). 2024 Sep 23;14(9):1207. doi: 10.3390/life14091207.
Italy was the first western country to be hit by the COVID-19 pandemic and has suffered nearly 200,000 deaths so far during the four years of the pandemic. In March 2020, Italy first deployed COVID-19 convalescent plasma (CCP) to treat hospitalized patients. Despite this initial effort, the proportion of COVID-19 patients treated with CCP during the first two years of the pandemic (2020-2021) was very low (approximately 2% of individuals hospitalized for COVID-19). In this study, we estimated the number of actual inpatient lives saved by CCP treatment in Italy using national mortality data, and CCP mortality reduction data from meta-analyses of randomized controlled trials and real-world data. We also estimated the potential number of lives saved if CCP had been deployed to 100% of hospitalized patients or used in 15% to 75% of outpatients. According to these models, CCP usage in 2020-2021 saved between 385-1304 lives, but this number would have increased to 17,751-60,079 if 100% of inpatients had been transfused with CCP. Similarly, broader (15-75%) usage in outpatients could have prevented 21,187-190,689 hospitalizations (desaturating hospitals) and 6144-81,926 deaths. These data have important implications for convalescent plasma use in future infectious disease emergencies.
意大利是首个受到新冠疫情冲击的西方国家，在疫情的四年间，该国迄今已有近20万人死亡。2020年3月，意大利首次部署新冠康复者血浆（CCP）来治疗住院患者。尽管有这一初步举措，但在疫情的头两年（2020 - 2021年），接受CCP治疗的新冠患者比例非常低（约占因新冠住院患者的2%）。在本研究中，我们利用国家死亡率数据以及来自随机对照试验和真实世界数据的荟萃分析中的CCP死亡率降低数据，估算了意大利CCP治疗实际挽救的住院患者生命数量。我们还估算了如果将CCP应用于100%的住院患者或15%至75%的门诊患者，可能挽救的生命数量。根据这些模型，2020 - 2021年使用CCP挽救了385 - 1304条生命，但如果100%的住院患者都接受CCP输血，这一数字将增至17751 - 60079条。同样，在门诊患者中更广泛地（15% - 75%）使用CCP本可避免21187 - 190689例住院（缓解医院压力）以及6144 - 81926例死亡。这些数据对未来传染病紧急情况中康复者血浆的使用具有重要意义。
