Compassionate use of convalescent plasma for the management of severe pneumonia in critically ill COVID-19 patients-a single center experience, Kerala, India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20213948Keywords:
Convalescent plasma therapy, Severe COVID-19, C reactive proteinAbstract
We assessed treatment effectiveness with convalescent plasma in critically ill COVID-19 pneumonia patients and their association with reduction in C reactive protein level as a sensitive inflammatory marker to the ongoing cytokine storm. Retrospective cohort study based on the detailed electronic medical chart review. The primary outcome was a clinical improvement on day 14, defined as the reduction in cytokine storm as demonstrated by a drop in acute phase reactant C reactive protein; de-escalation from the prior mode of oxygen delivery or not on mechanical ventilation in critically ill COVID-19 patients. C reactive protein was measured by using immunoturbidimetry. IgG antibody against spike protein S1 was measured by chemiluminescent immunoassay. Of 14 patients, all had severe COVID-19 pneumonia [category C], and 9 (64%) were mechanically ventilated soon after the admission into the medical intensive care unit. De-escalation of the oxygenation strategy mode was noted in 11 (79%) patients after convalescent plasma infusion. All patients showed a significant drop in C reactive protein when compared to pre-infusion and post-infusion day 5. Early compassionate use of convalescent plasma with higher titters of IgG antibodies against S1may positively benefit the overall outcome in critically ill COVID-19 patients with severe pneumonia.
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References
WHO Pandemia WHO Director-General’s opening remarks at the media briefing on COVID-19 2020. Available at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19? Accessed 25 December 2020.
COVID-19 Data Repository by Center for Systems Science and Engineering (CSSE) 2021.Available at Johns Hopkins University. Available at: https://github.com/CSSEGISandData/. Accessed 10 February 2021.
Montelongo-Jauregui D, Vila T, Sultan AS, Jabra-Rizk MA. Convalescent serum therapy for COVID-19: A 19th century remedy for a 21st century disease. PLoS Pathogens. 2020;16(8):e1008735.
Keller MA, Stiehm ER. Passive immunity in prevention and treatment of infectious diseases. Clin microbiol reviews. 2000;13(4):602-14.
Liao H. Current status and practical considerations in the development of convalescent plasma as a treatment for COVID‐19. ISBT Sci Series. 2020;15(4):403-14.
Yang X, Yu Y, Xu J. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centred, retrospective, observational study. Lancet Respir Med. 2020;8:475-81.
Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62.
Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46:846-8.
Liu XH, Lu SH, Chen J. Clinical characteristics of foreign- imported COVID-19 cases in Shanghai, China. Emerg Microbes Infect. 2020;9:1230-32.
Sharifpour M, Rangaraju S, Liu M, Alabyad D, Nahab FB, Creel-Bulos CM et al. COVID-19 Quality and Clinical Research Collaborative. C-Reactive protein as a prognostic indicator in hospitalized patients with COVID-19. PLoS One. 2020;15(11):e0242400.
Potempa LA, Rajab IM, Hart PC, Bordon J, Fernandez-Botran R. Insights into the use of C-reactive protein as a diagnostic index of disease severity in COVID-19 infections. Am j trop med hygiene. 2020;103(2):561.
Sahu BR, Kampa RK, Padhi A, Panda AK. C-reactive protein: a promising biomarker for poor prognosis in COVID-19 infection. Clinica chimica acta. 2020;509:91-4.
Rajendran K, Krishnasamy N, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID‐19: Systematic review. J med virol. 2020;92(9):1475-83.
COVID-19 Convalescent plasma, Letter of Authorization, US FDA (EUA 26382). 2020.
Clinical memorandum- COVID-19 Convalescent plasma, USFDA (EUA 26382). 2020.
Convalescent plasma- Letter of authorisation. 2.4.21 Final version for concurrence, USFDA .2021.
Convalescent plasma-Corona disease 2019 (COVID-19) treatment guidelines. Available at: www.covid19treatmentguidelines.nih.gov. Accessed 7 March 2021.
Shen C. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. Jama. 2020;323(16):1582-9.
Xingsheng Hu. Effectiveness of convalescent plasma therapy for COVID-19 patients in Hunan, China: Dose-Response. Int J. 2020:1-12.
Maor Y, Cohen D, Paran N, Israely T, Ezra V, Axelrod O et al. Compassionate use of convalescent plasma for treatment of moderate and severe pneumonia in COVID-19 patients and association with IgG antibody levels in donated plasma. E-Clin Med. 2020;26:100525.
Hartman WR, Hess AS, Connor JP. Hospitalized COVID-19 patients treated with convalescent plasma in a mid-size city in the Midwest. Translational med communications. 2020;5(1):1-6.
Liu ST, Lin HM, Baine I, Wajnberg A, Gumprecht JP, Rahman F et al. Convalescent plasma treatment of severe COVID-19: a propensity score–matched control study. Nature med. 2020;26(11):1708-13.
Salazar E, Christensen PA, Graviss EA, Nguyen DT, Castillo B, Chen J et al. Treatment of coronavirus disease 2019 patients with convalescent plasma reveals a signal of significantly decreased mortality. Am j pathol. 2020;190(11):2290-303.
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings National Academy Sci. 2020;117(17):9490-6.
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