Study of Effectiveness of Convalescent Plasma-therapy in Moderate to Severely ill COVID-19 Patients

Background : Convalescent Plasma-therapy, a classic adaptive immunotherapy used in the treatment of SARS, MERS and 2009 H1N1 pandemic with acceptable efficacy and safety in the past. Convalescent Plasma-therapy was taken into consideration in management of COVID-19 disease during the initial days of pandemic but was withdrawn later due to its doubtful beneficial role. This study aims to explore the beneficial role of Convalescent plasma and to determine whether Convalescent Plasma-therapy holds a second chance in treating SARS-CoV-2. Methods : This cross-sectional observational study includes 82 cases of moderate to severely ill COVID-19 patients who received Convalescent Plasma-therapy and 41 controls who didn抰. regular monitoring of Total Leukocyte Count (TLC), PaO2/FiO2 (PaO2 is partial pressure of Oxygen in arterial blood, fractional inspired oxygen (P/F ratio), Neutrophil to Lymphocyte Ratio (N/L ratio) inflammatory markers, respiratory rate, oxygen saturation, ABG and Radiological Imaging was done for comparative analysis. Results : In case group 39 patients (47.56%) were on oxygen mask, 17 patients (20.73%) on Non-invasive Ventilation (NIV), 9 Patients on Non-rebrether Mask (NRM) (10.97%), 16 patients (19.51%) on room air, 1(1.21%) on High Flow Nasal Cannula (HFNC) initially. After 7th day of Convalescent Plasma-therapy 49 patients (59.75%) were on room air which suggests significant improvement in mode of ventilation in case group as compared to Control Group. Mean respiratory rate in case group was 30.46 Cycles Per Minute (CPM) initially and 24.7 CPM on day 7th of Plasma-therapy which is statically significant. Conclusion : Plasma-therapy is effective if given in early stage of disease and Convalescent Plasma donors having adequate antibody titre.

Research progress of evidence-based medicine in clinical practice of plasmatransfusion / 中国输血杂志

Plasma is widely used in clinical, but the reliable evidence-based medical evidences that can guide clinicians to properly use plasma are limited, and inappropriate use may even cause deterioration of the disease and serious adverse reactions. Based on the relevant international blood transfusion guidelines and published clinical trial studies, this paper aims to summarize the evidence-based basis of plasma in clinical applications, discuss the safety and efficacy of plasma applications under different conditions, and provide assistance to clinical practice and scientific research of plasma in the future.

Convalescent plasma therapy - a silver lining for COVID-19 management?

ABSTRACT The COVID-19 pandemic has pushed the world towards social, economic, and medical challenges. Scientific research in medicine is the only means to overcome novel and complex diseases like COVID-19. To sum up the therapeutic wild-goose chase, many available antivirals and repurposed drugs have failed to show successful clinical evidence in patient recovery, several vaccine candidates are still waiting in the trial pipelines and a few have become available to the common public for administration in record time.However, with upcoming evidence of coronavirus mutations, available vaccines may thrive on the spirit of doubt about efficacy and effectiveness towards these new strains of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV2). In all these collective uncertainties, plasma therapy has shown a ray of hope for critically ill patients. To date, with very few published case studies of convalescent plasma in COVID-19, there are two school of thought process in the scientific community regarding plasma therapy efficiency and this leads to confusion due to the lack of optimal randomized and controlled studies.Without undertaking any robust scientific studies, evidence or caution, accepting any therapy unanimously may cause more harm than good, but with a clearer understanding of SARS-CoV2 immunopathology and drug response, plasma therapy might be the silver lining against COVID-19 for the global community.

Convalescent Plasma Therapy: A Novel Approach To A Novel Coronavirus

Objective: The Corona virus-induced disease-19 (COVID-19) turning to its aggressive phase of spreading, the treatment options where less and several options are trialing and seeking. Convalescent plasma therapy is one of the newest trailing therapy for COVID patients today without other definite treatment. The convalescent plasma (CP) therapy is used previously and identified its benefits in other conditions. But in the case of COVID 19 the effects and safety should be ensured for its implementation. Methods: Systematically searched in Pub Med and other authentic sources for articles of interest. Results: This review includes 5 studies, over all 26 patients who treated CP and following progressions and events. All became clinically better and the antibody titer increased in the patients. Not only that the viral load decreased with a reduction in inflammatory markers Conclusion: These small studies and case series suggest that CP is effective and safety is high for clinical recover and reduction in viral load.

Platelet-Rich Plasma (PRP) Therapy in Dermatology

Platelets present in the human blood produces a wide range of hormones. The activated forms of platelets are actively motile and their motility is clearly shown by the author in a video recorded through a simple microscope and uploaded in YouTube (Moving platelets & PRP_Dr Lokendra Yumnam at www.youtube.com/watch?v=du4nav0Fvy). The platelet-rich plasma can be prepared easily at any side-laboratory attached to the Dermatology OPD. The same may be used in treatment of many skin conditions previously thought to be very difficult to be treated. The author presents results of administering one PRP therapy in patients with androgenic alopecia, disfiguring lesions on face, recalcitrant ulcers including ulcers in leprosy patients, lichen sclerosus, vitiligo and also enhancing skin-graft uptake in scars. The results of PRP therapy in many refractory skin conditions are promising. More researches need to be taken up in this form of magical therapy. This may open up new avenues in the successful treatment of many skin conditions which are hitherto considered to be non-treatable.

Atypical Hemolytic Uremic Syndrome in a 13-year-old Lao Girl: A Case Report

Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (anti-CFH-aHUS) primarily affects children aged 9–13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.

Atypical hemolytic uremic syndrome and eculizumab therapy in children / 소아과

Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy. Eculizumab is a newly developed biologic that blocks the terminal complement pathway and has been successfully used in the treatment of aHUS. Currently, several guidelines for aHUS, including the Korean guideline, recommend eculizumab as the first-line therapy in children with aHUS. Moreover, life-long eculizumab therapy is generally recommended. Further studies on discontinuation of eculizumab are needed.