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. OBJECTIVEThis 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. METHODSThis 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. RESULTSMedian 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. CONCLUSIONSConvalescent 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.
ABSTRACT
Rationale@#COVID-19 is a new, rapidly emerging zoonotic infectious disease. Addressing the cytokine storm and coagulopathy associated with this disease can minimize its severity and complications. Therapeutic plasma exchange (TPE) can be potentially used to remove these deleterious cytokines and procoagulant proteins.@*Objective@#This study aims to assess the effectiveness and safety of TPE as an adjunctive treatment for COVID-19 patients.@*Research Design and Methodology@#A systematic search of databases was conducted utilizing PubMed and Cochrane databases to identify relevant literature until December 31, 2020. All publications were included if they use TPE in COVID- 19 patients. The exclusion was applied in publications written in language other than English, review papers, or on-going clinical trials. No restrictions on age, sex, or clinical setting were applied. The eligible studies were reviewed in full text independently by two authors. Methodological quality and risk of bias assessment were done. The findings from the individual studies were summarized.@*Results@#A total of 21 studies were included. Overall risk of bias was high within and across the studies. All studies reported marked improvement of clinical status and laboratory results after receiving the TPE. The use of TPE among COVID-19 patients resulted in no serious or life-threatening adverse events.@*Conclusion@#The available studies on the use of TPE for COVID-19 patients is still limited and evidence is of low certainty. However, based on the available data, it has an encouraging result to be used as effective and safe adjunctive treatment in COVID-19 patients.
