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鼻导管吸氧的COVID-19患者的恢复期血浆治疗

Convalescent plasma therapy for COVID-19 in patients with nasal catheter oxygen therapy.

作者信息

Chen Ran, Zhang Yingying, Liu Ying, Shi Dandan, Wang Chuwen, Ye Jinming, Yan Danying, Peng Mingxi, Lv Dingfeng, Qian Guoqing

机构信息

Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, China.

Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, China.

出版信息

J Thorac Dis. 2025 Jun 30;17(6):3532-3546. doi: 10.21037/jtd-2024-1991. Epub 2025 Jun 11.

Abstract

BACKGROUND

Numerous studies have demonstrated that convalescent plasma therapy reduces mortality in coronavirus disease 2019 (COVID-19) patients. Current guidelines recommend nasal catheter oxygen therapy for most hypoxic patients during the early stages of the illness. However, limited data are available regarding the efficacy of convalescent plasma therapy in patients already receiving oxygen therapy. Given the widespread use of nasal catheter oxygen therapy in hypoxic COVID-19 patients and the increasing evidence supporting the efficacy of convalescent plasma, this study aimed to evaluate the efficacy and safety of convalescent plasma therapy in COVID-19 patients who were receiving early oxygen therapy.

METHODS

A retrospective study was conducted at the First Affiliated Hospital of Ningbo University, analyzing 112 COVID-19 patients treated with convalescent plasma from December 2022 to July 2023. Data on demographics, laboratory tests, and plasma doses were collected before and after convalescent plasma transfusion, alongside standard care. The primary outcome was 28-day mortality, with laboratory parameters as secondary outcomes.

RESULTS

On day 28, the mortality rate was 20% in the convalescent plasma group compared to 44% in the standard-care group (P=0.008). In severe COVID-19 cases, mortality was 34% in the convalescent plasma group versus 59% in the standard-care group (P=0.04). Among patients who received nasal catheter oxygen therapy for 48 hours or longer, mortality was 21% in the convalescent plasma group compared to 42% in the standard-care group (P=0.02).

CONCLUSIONS

Convalescent plasma therapy administered to COVID-19 patients receiving nasal catheter oxygen therapy significantly reduced mortality at day 28.

摘要

背景

大量研究表明,恢复期血浆疗法可降低2019冠状病毒病(COVID-19)患者的死亡率。目前的指南建议,在疾病早期,大多数低氧患者采用鼻导管吸氧治疗。然而,关于恢复期血浆疗法对已接受吸氧治疗患者的疗效,现有数据有限。鉴于鼻导管吸氧疗法在低氧COVID-19患者中广泛应用,且越来越多的证据支持恢复期血浆的疗效,本研究旨在评估恢复期血浆疗法对接受早期吸氧治疗的COVID-19患者的疗效和安全性。

方法

在宁波大学附属第一医院进行了一项回顾性研究,分析了2022年12月至2023年7月期间接受恢复期血浆治疗的112例COVID-19患者。在恢复期血浆输注前后,收集患者的人口统计学、实验室检查数据以及血浆剂量,并给予标准治疗。主要结局指标为28天死亡率,实验室参数为次要结局指标。

结果

在第28天,恢复期血浆组的死亡率为20%,而标准治疗组为44%(P=0.008)。在重症COVID-19病例中,恢复期血浆组的死亡率为34%,标准治疗组为59%(P=0.04)。在接受鼻导管吸氧治疗48小时或更长时间的患者中,恢复期血浆组的死亡率为21%,标准治疗组为42%(P=0.02)。

结论

对接受鼻导管吸氧治疗的COVID-19患者进行恢复期血浆疗法可显著降低第28天的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a3/12268389/01d7e684cd82/jtd-17-06-3532-f1.jpg

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