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Convalescent plasma treatment is associated with lower mortality and better outcomes in high-risk COVID-19 patients - propensity-score matched case-control study.
Tworek, Adam; Jaron, Krzysztof; Uszynska-Kaluza, Beata; Rydzewski, Andrzej; Gil, Robert; Deptala, Andrzej; Franek, Edward; Wójtowicz, Rafal; Zycinska, Katarzyna; Walecka, Irena; Cicha, Malgorzata; Wierzba, Waldemar; Zaczynski, Artur; Król, Zbigniew J; Rydzewska, Grazyna.
  • Tworek A; Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland. Electronic address: adamtworek2@gmail.com.
  • Jaron K; Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Uszynska-Kaluza B; Blood Donation Center of Ministry of the Interior and Administration, Warsaw, Poland.
  • Rydzewski A; Department of Internal Medicine, Nephrology and Transplantation Medicine, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland; Centre of Postgraduate Medical Education, Warsaw, Poland.
  • Gil R; Clinical Department of Invasive Cardiology in Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland; Mossakowski Clinical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
  • Deptala A; Clinical Department of Oncology and Hematology in Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland; Medical University of Warsaw.
  • Franek E; Mossakowski Clinical Research Centre, Polish Academy of Sciences, Warsaw, Poland; Clinical Department of Internal Medicine, Endocrinology and Diabetology in Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Wójtowicz R; Clinical Department of Anesthesiology and Intensive Care Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Zycinska K; Medical University of Warsaw; Clinical Department of Rheumatology, Connective Tissue Diseases and Rare Diseases, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Walecka I; Dermatology Department, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland; Dermatology Department Centre of Postgraduate Medical Education, Warsaw, Poland.
  • Cicha M; Diagnostic Laboratory of Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Wierzba W; Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland; University of Humanities and Economics in Lódz, Satellite Campus in Warsaw, Warsaw, Poland.
  • Zaczynski A; Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Król ZJ; Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
  • Rydzewska G; Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland; Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Int J Infect Dis ; 105: 209-215, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1085545
ABSTRACT

OBJECTIVE:

This study aimed to investigate the efficacy and safety of convalescent plasma (CP) transfusion in a group of high-risk COVID-19 patients.

METHODS:

This prospective study included 204 patients from a single tertiary-care hospital, hospitalized with COVID-19, of whom 102 were treated with CP administration and standard care (PG) and 102 others who received standard care only (CG). The CG was selected from 336 hospitalized patients using the propensity-score matching (PSM) technique using age, MEWS score, and comorbidities. The primary outcome was mortality rate; secondary outcomes were the requirement of a ventilator, length of ventilator need, length of intensive care unit (ICU) stay, and length of overall hospital confinement. Additionally, parameters predicting death in COVID-19 patients were identified.

RESULTS:

Findings confirmed a significantly lower mortality rate in the PG versus the CG (13.7% vs. 34.3 %, p = 0.001) and a significant difference in the cumulative incidence of death between the two groups (p < 0.001). CP treatment was associated with lower risk of death (OR = 0.25 CI95 [0.06; 0.91], p = 0.041). There were no significant differences in ICU stay, ventilator time, and hospitalization time between the two groups.

CONCLUSIONS:

A significantly lower mortality rate was observed in the group of patients treated with CP. Age, presence of cardiac insufficiency, active cancer, a ventilator requirement, and length of hospitalization significantly increased the risk of death in both groups. Our study shows that CP affords better outcomes when administrated in the earlier stage of high-risk COVID-19 disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Propensity Score / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Propensity Score / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article