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Effect of Convalescent Plasma in Critically Ill Patients With COVID-19: An Observational Study.
Kurtz, Pedro; Righy, Cassia; Gadelha, Monica; Bozza, Fernando A; Bozza, Patricia T; Gonçalves, Bruno; Bastos, Leonardo S L; Vale, Andre M; Higa, Luiza M; Castilho, Leda; Monteiro, Fabio L; Charris, Nestor; Fialho, Fernanda; Turon, Ricardo; Guterres, Alexandro; Lyra Miranda, Renan; de Azeredo Lima, Carlos Henrique; de Caro, Vanessa; Prazeres, Marco Aurelio; Ventura, Nina; Gaspari, Clara; Miranda, Fabio; Jose da Mata, Paulo; Pêcego, Margarida; Mateos, Sheila; Lopes, Maria Esther; Castilho, Shirley; Oliveira, Álvaro; Boquimpani, Carla; Rabello, Andréa; Lopes, Josiane; Neto, Orlando Conceição; Ferreira, Orlando da C; Tanuri, Amilcar; Filho, Paulo Niemeyer; Amorim, Luiz.
  • Kurtz P; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Righy C; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Gadelha M; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Bozza FA; D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
  • Bozza PT; National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Gonçalves B; Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Bastos LSL; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Vale AM; Industrial Engineering Department, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.
  • Higa LM; Laboratory of Lymphocyte Biology, Program in Immunobiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
  • Castilho L; Laboratory of Molecular Virology, Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Monteiro FL; Laboratory of Cell Culture Engineering, COPPE, Chemical Engineering Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
  • Charris N; Laboratory of Molecular Virology, Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Fialho F; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Turon R; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Guterres A; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Lyra Miranda R; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • de Azeredo Lima CH; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • de Caro V; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Prazeres MA; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Ventura N; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Gaspari C; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Miranda F; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Jose da Mata P; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Pêcego M; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
  • Mateos S; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Lopes ME; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Castilho S; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Oliveira Á; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Boquimpani C; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Rabello A; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Lopes J; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Neto OC; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Ferreira ODC; Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil.
  • Tanuri A; Laboratory of Molecular Virology, Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Filho PN; Laboratory of Molecular Virology, Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Amorim L; Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
Front Med (Lausanne) ; 8: 630982, 2021.
Article in English | MEDLINE | ID: covidwho-1082440
ABSTRACT

Background:

Convalescent plasma is a potential therapeutic option for critically ill patients with coronavirus disease 19 (COVID-19), yet its efficacy remains to be determined. The aim was to investigate the effects of convalescent plasma (CP) in critically ill patients with COVID-19.

Methods:

This was a single-center prospective observational study conducted in Rio de Janeiro, Brazil, from March 17th to May 30th, with final follow-up on June 30th. We included 113 laboratory-confirmed COVID-19 patients with respiratory failure. Primary outcomes were time to clinical improvement and survival within 28 days. Secondary outcomes included behavior of biomarkers and viral loads. Kaplan-Meier analyses and Cox proportional-hazards regression using propensity score with inverse-probability weighing were performed.

Results:

41 patients received CP and 72 received standard of care (SOC). Median age was 61 years (IQR 48-68), disease duration was 10 days (IQR 6-13), and 86% were mechanically ventilated. At least 29 out of 41CP-recipients had baseline IgG titers ≥ 11,080. Clinical improvement within 28 days occurred in 19 (46%) CP-treated patients, as compared to 23 (32%) in the SOC group [adjusted hazard ratio (aHR) 0.91 (0.49-1.69)]. There was no significant change in 28-day mortality (CP 49% vs. SOC 56%; aHR 0.90 [0.52-1.57]). Biomarker assessment revealed reduced inflammatory activity and increased lymphocyte count after CP.

Conclusions:

In this study, CP was not associated with clinical improvement or increase in 28-day survival. However, our study may have been underpowered and included patients with high IgG titers and life-threatening disease. Clinical Trial Registration The study protocol was retrospectively registered at the Brazilian Registry of Clinical Trials (ReBEC) with the identification RBR-4vm3yy (http//www.ensaiosclinicos.gov.br).
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.630982

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.630982