ABSTRACT
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients. Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ≥ 20/min, blood oxygen saturation ≥ 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes. Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ≥ 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed. Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.
ABSTRACT
Background: Hypertension is a critical risk factor in increasing the mortality rate of COVID-19 inpatients. This association can be confounded by a history of consuming some angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs). Objective: This study aimed to assess the COVID-19 prognosis in patients with/without a history of taking ACEIs and ARBs. Methods: This single-center, prospective, observational study was performed on 345 patients with COVID-19 hospitalized in Baqiyatallah Hospital. The patients were categorized into 2 groups: with a history of ACEI/ARB consumption (the case group, n=115) and without such a history (the control group, n=230). Results: After the exclusion of some patients, the COVID-19 prognosis of 294 patients (ncontrol =184, ncase=110, 53% female) at a mean age of 64±9.7 years was evaluated. Unequal variables were adjusted between the case and control groups, and the results showed no significant differences in oxygen saturation, the computed tomography scan score, the erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase, D-dimer, the white blood cell count, lymphocytes, hemoglobin, platelets, and mortality between the 2 groups. However, a significant difference in the average length of hospital stay was found between the control (6.55±0.56 d) and case (8.53±0.55 d) groups (P=0.013). Conclusions: The dosage adjustments and changes of ACEIs and ARBs are not recommended due to increased referrals to health centers involved with the COVID-19 risk. The prognosis, safety, and efficacy of ACEI/ARB consumption should be assessed further in larger studies on middle-aged to old patients with COVID-19. (Iranian Heart Journal 2022;23(1): 129-139).
ABSTRACT
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients.