ABSTRACT
Aims:This case-control prospective study aimed to describe the effects of COVID convalescent plasma (CCP) on late mortality in hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia. StudyDesign:In this study were enrolled 214 consecutive patients with moderate to severe COVID-19 pneumonia hospitalized during the fourth trimester of 2020 in Venice Prefecture (North-East Italy). admitted to COVID-19 Hospitals of our district were enrolled.Methodology: Confirmation of SARS-CoV-2 infection was made through reverse transcription-polymerase chain reaction test in nasopharyngeal swabs. The severity of each patient’s clinical condition was determined considering the Berlin scoreradiological findings and ventilatory data. Clinical data, risk factors and comorbidity, laboratory test reports and imaging diagnosis of all patients were recorded at hospitalization. In Italy, during the fourth trimester 2020 standard therapy for COVID-19 Pneumoniawas: NSAIDs, ventilator support, LMWH, steroids, antibiotics and antiviral drugs; 108 patients received standard therapy alone and 106 received standard therapy in combination with CCP. The endpoint was mortality at 30 days.Results:Patients series were comparable for gender, age, comorbidity and risk factors, Berlin score, PaO2/FiO2. Data concerning radiological findings and data concerning ventilatory support suggested a higher severity of patients treated with standard therapy plus CCP.Mortality rateat 30 days was 30.6% among subjects treated with standard therapy versus 30.2% among subjects treated with standard therapy plus CCP. The mortality observed in the two groups did not differ significantly. In the present study, however, we observed a higher mortality than reported in the literature. This result may be attributable to the greater severity of the patients considered.Conclusions:This case-control prospective study showed that in a cohort of hospitalized patients suffering from severe 19 pneumonia, the addition of CCP to the standard therapy did not impact the mortality rate at 30 days. However, we believe that further studies are needed to evaluate the effectiveness of convalescent plasma therapy.
ABSTRACT
Background:This was a single center prospective study about factors related with mortality in hospitalized patients with severe COVID-19 pneumonia treated with convalescent plasma (CCP) infusion in Venice Prefecture. Methods:In this study were enrolled all the (376) consecutive hospitalized patients with severe COVID-19 pneumonia treated with CCP observed from 30/04/2020 to 31/10/2021. At hospital admission, in order to evaluate correlation with prognosis, study recorded demographic data, clinical data, presence of co morbidities, Rx findings, laboratory results. The endpoint was mortality at 30 days.Results:Using multivariate analysis, consideringdemographic data and co morbiditiesfour variables emerged as significant independent predictors of 30-day mortality: age>70 years, tobacco smoke, obesity (BMI>30), Diabetes. Considering Patients’ clinical characteristics at hospital admissiontwo variables emerged as significant independent predictors of 30-day mortality in this cohort of hospitalized patients with severe COVID-19 Pneumonia: PaO2/FiO2 ratio under 200 and lungs imaging with a score >3. Discussion:Late mortality was investigated in a series of consecutive, hospitalized, patients with severe COVID-19. We therefore believe that any influence linked to the level of expertiseof the clinical staff and available technology was minimal.Furthermore, we also tried to reduce, as much as possible, the variables related CCP infusion using plasma with a neutralizing antibody titer>80 and a standardized dose: a 200 mL unit per day for three consecutive days. Moreover, using both a univariate and multivariate analytical approach, numerous demographic variables were considered, relating to comorbidities, all clinical characteristics, to laboratory data; correlating them with mortality at 30 days.