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Effectiveness of Convalescent Plasma Therapy in Severe or Critically Ill COVID-19 Patients: A Retrospective Cohort Study

최재필|이경화|김신영|안진영|정수진|염준섭|안미영|손유진|현종훈|최준용|백예지|구남수|송영구|오동현|김무현|김정호|조윤숙
연세대학교의과대학 (Yonsei University College of Medicine)|2021.09|Yonsei Medical Journal|제62권 제9호|pp. 799-805|DOI 10.3349/ymj.2021.62.9.799

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키워드

COVID-19neutralizing antibodyConvalescent plasma treatmentcycle threshold (Ct) value
주제분류의학일반

초록

Purpose: Coronavirus disease-2019 (COVID-19) is a novel respiratory infectious disease caused by severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2); there are few specific treatments. Convalescent plasma (CP), donated by people who haverecovered from COVID-19, is an investigational therapy for severe or critically ill patients with COVID-19. Materials and Methods: This retrospective cohort study evaluated the effectiveness of CP therapy in patients with severe or lifethreateningcases of COVID-19 at two hospitals in Seoul, Korea, between May and September 2020. Clinical outcomes were evaluatedin 20 patients with CP therapy in a descriptive manner. Additionally, the changes in cycle threshold (Ct) values of 10 patientswith CP therapy were compared to those of 10 controls who had the same (±0.8) initial Ct values but did not receive CP. Results: Of the 20 patients (mean age 66.6 years), 18 received high-dose oxygen therapy using mechanical ventilators or high-flownasal cannulas. Systemic steroids were administered to 19 patients who received CP. The neutralizing antibody titers of the administeredCP were between 1:80 and 1:10240. There were two ABO-mismatched transfusions. The World Health Organization ordinalscale score and National Institutes of Health severity score improved in half of the patients within 14 days. Those who received CPshowed a higher increase in Ct values at 24 h and 72 h after CP therapy compared to controls with similar initial Ct values (p=0.002). No transfusion-related side effects were observed. Conclusion: CP therapy may be a potential therapeutic option in severe or critically ill patients with COVID-19.

Abstract

Purpose: Coronavirus disease-2019 (COVID-19) is a novel respiratory infectious disease caused by severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2); there are few specific treatments. Convalescent plasma (CP), donated by people who haverecovered from COVID-19, is an investigational therapy for severe or critically ill patients with COVID-19. Materials and Methods: This retrospective cohort study evaluated the effectiveness of CP therapy in patients with severe or lifethreateningcases of COVID-19 at two hospitals in Seoul, Korea, between May and September 2020. Clinical outcomes were evaluatedin 20 patients with CP therapy in a descriptive manner. Additionally, the changes in cycle threshold (Ct) values of 10 patientswith CP therapy were compared to those of 10 controls who had the same (±0.8) initial Ct values but did not receive CP. Results: Of the 20 patients (mean age 66.6 years), 18 received high-dose oxygen therapy using mechanical ventilators or high-flownasal cannulas. Systemic steroids were administered to 19 patients who received CP. The neutralizing antibody titers of the administeredCP were between 1:80 and 1:10240. There were two ABO-mismatched transfusions. The World Health Organization ordinalscale score and National Institutes of Health severity score improved in half of the patients within 14 days. Those who received CPshowed a higher increase in Ct values at 24 h and 72 h after CP therapy compared to controls with similar initial Ct values (p=0.002). No transfusion-related side effects were observed. Conclusion: CP therapy may be a potential therapeutic option in severe or critically ill patients with COVID-19.

참고문헌 (40)

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