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Convalescent plasma therapy and mortality in COVID-19 patients admitted to the ICU: a prospective observational study.
Hatzl, Stefan; Posch, Florian; Sareban, Nazanin; Stradner, Martin; Rosskopf, Konrad; Reisinger, Alexander C; Eller, Philipp; Schörghuber, Michael; Toller, Wolfgang; Sloup, Zdenka; Prüller, Florian; Gütl, Katharina; Pilz, Stefan; Rosenkranz, Alexander R; Greinix, Hildegard T; Krause, Robert; Schlenke, Peter; Schilcher, Gernot.
  • Hatzl S; Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Posch F; Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Sareban N; Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Stradner M; Department for Blood Group Serology and Transfusion Medicine, Medical University Graz, Graz, Austria.
  • Rosskopf K; Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Reisinger AC; Department for Blood Group Serology and Transfusion Medicine, Medical University Graz, Graz, Austria.
  • Eller P; Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Schörghuber M; Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Toller W; Department of Anesthesiology and Intensive Care Medicine, Medical University Graz, Graz, Austria.
  • Sloup Z; Department of Anesthesiology and Intensive Care Medicine, Medical University Graz, Graz, Austria.
  • Prüller F; Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
  • Gütl K; Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
  • Pilz S; Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Rosenkranz AR; Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Greinix HT; Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Krause R; Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Schlenke P; Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria. robert.krause@medunigraz.at.
  • Schilcher G; Department for Blood Group Serology and Transfusion Medicine, Medical University Graz, Graz, Austria.
Ann Intensive Care ; 11(1): 73, 2021 May 12.
Article in English | MEDLINE | ID: covidwho-1225785
ABSTRACT

BACKGROUND:

This study aimed to quantify the potential survival benefit of convalescent plasma therapy (CVP) in critically ill patients with acute respiratory failure related to coronavirus disease-2019 (COVID-19).

METHODS:

This is a single-center prospective observational cohort study in COVID-19 patients with acute respiratory failure. Immediately after intensive care unit (ICU) admission patients were allocated to CVP treatment following pre-specified criteria to rapidly identify those patients potentially susceptible for this treatment. A propensity score adjustment [inverse probability of treatment weighted (IPTW) analysis] was implemented to account rigorously for imbalances in prognostic variables between the treatment groups.

RESULTS:

We included 120 patients of whom 48 received CVP. Thirty percent were female with a median age of 66 years [25th-75th percentile 54-75]. Eighty-eight percent of patients presented with severe acute respiratory failure as displayed by a median paO2/FiO2 ratio (Horowitz Index) of 92 [77-150]. All patients required any kind of ventilatory support with more than half of them (52%) receiving invasive ventilation. Thirty-day ICU overall survival (OS) was 69% in the CVP group and 54% in the non-CVP group (log-rank p = 0.049), respectively. After weighing the time-to-event data for the IPTW, the favorable association between CVP and OS became even stronger (log-rank p = 0.035). Moreover, an exploratory analysis showed an overall survival benefit of CVP therapy for patients with non-invasive ventilation (Hazard ratio 0.12 95% CI 0.03-0.57, p = 0.007)

CONCLUSION:

Administration of CVP in patients with acute respiratory failure related to COVID-19 is associated with improved ICU survival rates.
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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: Ann Intensive Care Year: 2021 Document Type: Article Affiliation country: S13613-021-00867-9

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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: Ann Intensive Care Year: 2021 Document Type: Article Affiliation country: S13613-021-00867-9