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Rev. invest. clín ; 72(3): 159-164, May.-Jun. 2020. tab, graf
Article Dans Anglais | LILACS | ID: biblio-1251850

Résumé

ABSTRACT Background: The ideal treatment of coronavirus disease (COVID)-19 has yet to be defined, but convalescent plasma (CoPla) has been successfully employed. Objective: The objective of the study was to study the safety and outcomes of the administration of CoPla to individuals with severe COVID-19 in an academic medical center. Methods: Ten patients were prospectively treated with plasma from COVID-19 convalescent donors. Results: Over 8 days, the sequential organ failure assessment score dropped significantly in all patients, from 3 to 1.5 (p = 0.014); the Kirby index (PaO2/FiO2) score increased from 124 to 255, (p < 0.0001), body temperature decreased significantly from 38.1 to 36.9°C (p = 0.0058), and ferritin levels also dropped significantly from 1736.6 to 1061.8 ng/ml (p = 0.0001). Chest X-rays improved in 7/10 cases and in 6/10, computerized tomography scans also revealed improvement of the lung injury. Decreases in C-reactive protein and D-dimer levels were also observed. Three of five patients on mechanical ventilation support could be extubated, nine were transferred to conventional hospital floors, and six were sent home; two patients died. The administration of CoPla had no side effects and the 24-day overall survival was 77%. Conclusions: Although other treatments were also administered to the patients and as a result data are difficult to interpret, it seems that the addition of CoPla improved pulmonary function.


Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Jeune adulte , Pneumopathie virale/thérapie , Infections à coronavirus/thérapie , Betacoronavirus/isolement et purification , Betacoronavirus/immunologie , Plasma sanguin , Indice de gravité de la maladie , Température du corps , Protéine C-réactive/analyse , Marqueurs biologiques , Tomodensitométrie , Projets pilotes , Convalescence , Immunisation passive , Résultat thérapeutique , Infections à coronavirus/traitement médicamenteux , Infections à coronavirus/imagerie diagnostique , Association thérapeutique , Estimation de Kaplan-Meier , Ferritines/sang , Pandémies , SARS-CoV-2 , COVID-19 , Poumon/imagerie diagnostique , Anticorps antiviraux/sang
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