ABSTRACT
Background and Objective. Convalescent plasma therapy (CPT) may reduce the risk of disease progression among patients with COVID-19. This study was undertaken to evaluate the efficacy and safety of CPT in preventing ICU admission among hospitalized COVID-19 patients. Methods. In this open-label randomized controlled trial, we randomly assigned hospitalized adult patients with COVID-19 in a 1:1 ratio to receive convalescent plasma as an adjunct to standard of care or standard of care alone. The primary endpoint was ICU admission within first 28 days of enrolment. Primary safety endpoints include rapid deterioration of respiratory or clinical status within four hours of convalescent plasma transfusion and cumulative incidence of serious adverse events during the study period including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), severe allergic reactions, and transfusion-related infections. Results. A total of 22 patients were assigned to receive convalescent plasma as an adjunct to standard of care and 22 to receive standard of care alone. The median time from onset of COVID-19 symptoms to study enrolment was eight days (IQR, 4 to 10). Two patients (9.1%) in the CPT group and one patient (4.5%) in the control group were admitted to the ICU. The primary outcome measure, ICU admission, was not different between the two groups (q-value >0.9). No patient who received convalescent plasma had rapid deterioration of respiratory/clinical status within four hours of transfusion and none developed TRALI, TACO, anaphylaxis, severe allergic reactions, or transfusion-related infections. There was also no significant difference in the secondary outcomes of 28-day mortality (two patients in the CPT group and none in the control group, q-value >0.90), dialysis-free days, vasopressor-free days, and ICU-free days. Conclusions. Among hospitalized COVID-19 patients, no significant differences were observed in the need for ICU admission between patients given CPT as adjunct to standard of care and those who received standard of care alone. Interpretation is limited by early termination of the trial which may have been underpowered to detect a clinically important difference. © 2023 University of the Philippines Manila. All rights reserved.
ABSTRACT
Feline coronavirus (FCoV) is an important virus that can be differentiated into two serotypes: feline enteric coronavirus (FECoV) and feline infectious peritonitis (FIP) virus (FIPV). Researchers have suggested that a mutation of FECoV to FIPV leads to the emergence of FIP, a disease with worldwide distribution and a high mortality rate. Furthermore, in December 2019, a human infectious disease, coronavirus disease-2019 (COVID-19), which is also caused by a coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged, and clarity regarding its relationship with FCoV remains lacking. Studies have shown that cats are susceptible to infection with this novel coronavirus (i.e., SARS-CoV-2). The aim of the present study was to detect and semi-quantify the presence of feline antibodies to FIPV in cats examined at the Veterinary Hospital of Santa Cruz State University, microregion of Ilheus and Itabuna, Bahia, Brazil, between January and April 2018. Blood samples were collected from 68 domestic cats to perform complete blood count (CBC) and biochemical tests, and an indirect fluorescent antibody test (IFAT) was used to detect FCoV infection. Of the 68 samples evaluated, seropositivity was observed in 4.4% (3/68) at titers of 1:20;only one sample remained seropositive at titers of 1:40 and 1:80. Two positive animals exhibited CBC and biochemical values within the normal range, while the other positive animals exhibited a mild decrease in platelet count (173,000 uL-1), mild lymphocytosis (7395 uL-1), and mildly increased alkaline phosphatase level (134 uL-1). Twelve months after the tests, none of the positive animals exhibited clinical signs consistent with FIP. Although the IFAT can facilitate diagnosis of FPIV, it cannot be used to differentiate antibodies for the FECoV and FIPV serotypes. Results of the present study demonstrated that FCoV was present in the population studied, and is an important risk factor for the development of FIP. In addition, the new COVID-19 pandemic highlights the importance of studies investigating FCoV because it was not possible to rule out, until now, the possibility of FCoV mutations in infected cats if it encounters SARS-CoV-2.