Impact of Time and Mechanical Ventilation on Convalescent Plasma in Severe/Critically Ill COVID-19 Patients
نویسندگان
1 Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences
2 Darman Ara PJS Company
3 Darman Ara PJS Company
4 Student Research Committee, Baqiyatallah University of Medical Sciences
5 Student Research Committee, Baqiyatallah University of Medical Sciences
6 International Affairs Department, Iranian Blood Transfusion Organization
7 Department of Radiology, Baqiyatallah University of Medical Sciences and Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences
8 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences
9 Trauma Research Center, Baqiyatallah University of Medical Sciences
10 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences
11 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences
12 Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences
13 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences
14 Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences
15 Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences
16 Student Research Committee, Baqiyatallah University of Medical Sciences
17 Student Research Committee, Baqiyatallah University of Medical Sciences
18 Student Research Committee, Baqiyatallah University of Medical Sciences
19 Student Research Committee, Baqiyatallah University of Medical Sciences
20 Iranian Blood Transfusion Research Center, High Institute for Education and Research in Transfusion Medicine
21 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences
22 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences
23 Trauma Research Center, Baqiyatallah University of Medical Sciences
24 Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences
25 Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences; Tehran, Iran
doi
10.32592/ircmj.2021.23.9.802چکیده
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients. Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ? 20/min, blood oxygen saturation ? 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes. Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ? 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed. Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.
