ABSTRACT
ABSTRACT The COVID-19 disease caused by SARS-CoV2 virus has gripped the whole world with overwhelming strain in our health system. Currently, there are no standard guidelines in its treatment but the possible benefits of convalescent plasma in limiting complications and severity of the COVID-19 disease have emerged. OBJECTIVE: This study aims to determine the effectiveness and safety of using convalescent plasma in improving the clinical course of hospitalized patients diagnosed with COVID-19 disease admitted at University of Santo Tomas and Makati Medical Center. METHODS: This study is a quasi-experimental (prospective analytical), and multi-center study involving 65 patients diagnosed with COVID-19 Disease who received convalescent plasma, with 65 patients who only received best available treatment serving as age-gender-matched control. RESULTS: Median age of the population who received convalescent plasma was 60 years old, mostly male (68%), and manifested severe pneumonia (47%). There was noted statistically signifcant decrease between the pre-and post-treatment values of hemoglobin (p=0.04) and LDH (p=0.086). There was also statistically significant increase in platelet counts (p=0.01). WBC and PaO2 increased while ferritin and PFR decreased after convalescent plasma transfusion, however, these were not statistically significant. Length of stay and clinical outcome of those who received convalescent plasma were then compared to age-gender matched controls who only received best available treatment. There was noted statistically significant difference between length of stay (p=0.00) among those who received convalescent plasma as compared to those who did not. This was seen across severe and critically ill COVID-19 patients. There was also more mortality seen in the best available treatment alone group, but this was non-significant. CONCLUSIONS: Convalescent plasma use showed no significant impact in the recovery rate and outcome of patients who received it as compared to those who did not, however, its use was proven to be safe among all patients regardless of the level of severity and clinical profile.
Subject(s)
COVID-19 , PneumoniaABSTRACT
Background: Despite its high prevalence, published data on COVID-19 infection in obese subjects remains limited. When compared to early-onset diabetes, chronic obstructive pulmonary disease (COPD), advanced age, hypertension (HTN), immunosuppression, and chronic kidney disease (CKD), obesity was the only comorbidity that conferred an increased risk of death exclusively for COVID-19 compared to non-COVID- 19 patients. Any degree of obesity has been associated with poor prognosis in patients with COVID-19 and the risk of mechanical ventilation (MV) is the greatest in patients with BMI > 35 kg/m2, independent of age, diabetes, and hypertension. The aim of our study is to examine the association between various degrees of obesity and the clinical outcomes of patients with COVID-19 infection. Methods: This is a retrospective multicenter cohort study of adult patients with a BMI ≥30 kg/m2 presenting to six hospitals in the New York metropolitan region between March 7 and June 7, 2020, with COVID-19 infection. The clinical outcome assessed included hospitalization, in-hospital mortality, intensive care unit (ICU) admission, and MV. Outcomes were compared using a multivariate Cox regression model and Propensity Score matching model. Results: The study population comprised 9,991 patients, of whom 53.43% were obese (BMI ≥30 kg/m2). Higher comorbidity burdens, including HTN, Diabetes, CKD, and smoking, were noted in those with Class I and II obesity, relative to Class III obesity (44.54% & 38.00% vs. 22.94%). Obesity increases the risk for in-hospital mortality and intubation across all BMI ranges. Individuals with a BMI ≥ 30 were observed to have the highest risk of ICU admissions (OR 1.29;1.2-1.48;p < 0.001). There were higher rates of in-hospital mortality among obese patients across all BMI [BMI ≥ 30 (OR 1.23;1.09-1.40, p < 0.001);BMI ≥ 35 (OR 1.48;1.28-1.70, p < 0.001);BMI ≥ 40 (OR 1.81;1.55-2.13, p < 0.001). Conclusions: Obesity is an independent risk factor for increased mortality in those with COVID-19 infection. Data from this study supports and further expands the existing knowledge on the relationship between obesity and COVID-19 infection. Clinicians must focus on early prevention and management of obesity.