A retrospective cross-sectional study on the efficacy of immune plasma in critical COVID-19 patients under intensive care follow-up

Sevgi Kutlusoy, Erdi Koca, Mesut Oterkus
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Abstract

Many methods have been attempted for the treatment of severe acute respiratory failure caused by COVID-19. One of these methods is immune plasma therapy. In this study, we aimed to evaluate the efficacy of immune plasma therapy using laboratory parameters and the effect of the time of initiation of immune plasma therapy on mortality in patients with COVID-19 who developed severe acute respiratory failure. 74 patients who were diagnosed with COVID-19 during hospitalization and given immune plasma in the intensive care unit were included in our study. Demographic data, comorbid diseases, time of immune plasma administration (first 4 days and after the 4th day), and laboratory and mortality data before and 1 and 2 days after plasma administration were recorded retrospectively. Analysis of the data we obtained in our study showed no difference in mortality between immune plasma administration within the first 4 days and after 4 days. In the group that received immune plasma transfusions in the first 4 days, glucose was lower, while creatinine and AST values were higher. The urea, leukocyte, neutrophil, PO2, PCO2, PCT, and D-dimer values of the patients 1 day and 2 days after immune plasma transfusion was higher than the pre-transfusion values, while CK, albumin and CRP values were lower. Immune plasma transfusion therapy improved laboratory parameters supporting clinical improvement due to decreased viral load in patients with COVID-19 who developed severe acute respiratory failure; however, it did not affect mortality and the number of patients discharged was higher in the group given early treatment (first 4 days). We suggest that early immune plasma administration may be an adjunctive treatment option to improve clinical recovery and reduce mortality until a definitive and permanent cure is found under pandemic conditions.
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COVID-19重症监护随访中免疫血浆疗效的回顾性横断面研究
对于COVID-19引起的严重急性呼吸衰竭,已经尝试了许多治疗方法。其中一种方法是免疫血浆疗法。在本研究中,我们旨在通过实验室参数评估免疫血浆治疗的疗效,以及免疫血浆治疗开始时间对发生严重急性呼吸衰竭的COVID-19患者死亡率的影响。我们的研究纳入了74例住院期间被诊断为COVID-19并在重症监护病房给予免疫血浆的患者。回顾性记录患者的人口学资料、合并症、免疫血浆给药时间(前4天及后4天)、给药前及给药后1、2天的实验室和死亡率资料。我们在研究中获得的数据分析显示,免疫血浆在前4天内和4天后的死亡率没有差异。前4天免疫血浆输注组血糖较低,肌酐和AST值较高。免疫血浆输注后1天、2天患者的尿素、白细胞、中性粒细胞、PO2、PCO2、PCT、d -二聚体值均高于输注前,CK、白蛋白、CRP值均低于输注前。由于COVID-19患者发生严重急性呼吸衰竭的病毒载量下降,免疫血浆输血治疗改善了实验室参数,支持临床改善;但不影响死亡率,且早期治疗组(前4天)出院人数较高。我们建议,早期免疫血浆给药可能是一种辅助治疗选择,以提高临床恢复和降低死亡率,直到在大流行条件下找到最终和永久的治愈方法。
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