新型冠状病毒感染重症监护病房患者免疫血浆治疗效果评价

E. Yıldız, Murat Emre Tokur, Bugra Özlem, Özlem Arık, Canan Balcı
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摘要

前言:COVID-19感染的治疗方法包括抗病毒、免疫调节和支持治疗。恢复期血浆、免疫血浆或高免疫血浆是指含有抗病毒的高效价多克隆抗体并正在进行免疫调节治疗的血浆。虽然有报道称免疫血浆治疗COVID-19可减少住院时间和死亡率,但免疫血浆治疗COVID-19感染的疗效尚不清楚。本研究旨在探讨免疫血浆在重症监护病房诊断为COVID-19的患者随访中的效果。材料与方法:本回顾性研究将诊断为COVID-19感染的重症监护病房住院患者分为两组:接受IP治疗的患者(第一组;n=28)和未接受治疗的组(第二组;n = 25)。各组患者的生化C -反应蛋白、乳酸脱氢酶、铁蛋白、d -二聚体、总胆红素、肌酸水平、血液学指标(白细胞、中性粒细胞、淋巴细胞、血小板计数)、临床脓毒症评分(SOFA、APACHE评分)及死亡率。结果:1组与2组在机械通气支持、气管切开术、合并症、实验室值、C反应蛋白、SOFA、APACHE评分方面差异无统计学意义。组1死亡率为61%,组2死亡率为52%。结论:免疫血浆治疗对COVID-19感染重症监护病房患者的康复和降低死亡率没有效果。需要进一步的研究来调查在高炎症过程开始之前给予免疫调节疗法对结果的疗效。
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Evaluation of the efficacy of immune plasma treatment in COVID-19 infected intensive care unit patients
Introduction: Treatment approach in COVID-19 infection consists of antiviral, immunomodulatory, and supportive treatments. Convalescent plasma, immune plasma or hyperimmune plasma refers to the plasma that consisting of high titer polyclonal antibodies against the virus and are amidst the immunomodulatory treatments. Although it has been reported that immune plasma treatment of COVID-19 reduces hospital stay and mortality, the efficacy of immune plasma with COVID-19 infection is not clear yet. The present study aims to investigate the efficacy of immune plasma in patients who are followed up in the intensive care unit with the diagnosis of COVID-19. Materials and methods: In this retrospective study, the patients who were hospitalized in the intensive care unit with the diagnosis of COVID-19 infection were divided into two groups: those who received IP treatment (Group 1; n=28) and those who did not (Group 2; n=25). The biochemical C -reactive protein, lactate-dehydrogenase, ferritin, D-dimer, total bilirubin, creatine levels, hematological parameters (Leukocyte, neutrophil, lymphocyte, platelet counts), clinical sepsis scores (SOFA, APACHE scores) and mortality rates of the patients were evaluated according to groups. Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the presence of mechanical ventilation support and tracheostomy, comorbidities, laboratory values, C -reactive protein, SOFA, APACHE scores. The mortality rate was 61% in Group 1 and 52% in Group 2. Conclusions: Our findings revealed that immune plasma treatment was not effective in recovery and decreasing the mortality rates in the COVID-19 infected intensive care unit patients. Further studies are needed to investigate the efficacy of administering immunomodulatory therapies on the outcome before the hyper inflammatory process starts.
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