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was taken into consideration in management of COVID-19 disease during the initial days of pandemic but was withdrawn later due to its doubtful beneficial role.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.

Giant primary pulmonary fibrosarcoma.

A rare case of primary fibrosarcoma in a 48-year-old male is described who presented with a huge pulmonary mass on the left side. The diagnosis was established on fine needle aspiration cytology (FNAC) and percutaneous transthoracic lung biopsy, supported by immuno-histochemistry.

Tuberculosis of the middle ear with post auricular abscess.

A case of tuberculous otitis media with post auricular abscess is being described in a 14 year old female patient in view of its rare occurrence. The diagnosis was made on demonstration of acid fast bacilli (AFB) in the ear discharge and characteristic cytological features of post auricular abscess aspirate.

Recurrent haemoptysis following sildenafil administration.

Sildenafil is widely used in the treatment of male erectile disorder and is generally well-tolerated. Its adverse effects are reported to be mild and include flushing, headache, dyspepsia and visual disturbances. We document a case of recurrent haemoptysis observed soon after self administration of sildenafil in a 38-year-old male with no other causative factors. The episodes of haemoptysis stopped following stoppage of sildenafil.

Tuberculosis of oral cavity.

Tuberculous involvement of oral cavity is very rare. A 34-year-old male presented with non-healing ulcer at upper lip mucosa. Biopsy from ulcer revealed tuberculous lesion. He also had asymptomatic pulmonary tuberculosis diagnosed during work up for primary site of the disease.