Clinical predictors of donor antibody titer and correlation with recipient antibody response in a COVID-19 convalescent plasma clinical trial

BackgroundConvalescent plasma therapy for COVID-19 relies on the transfer of anti-viral antibody from donors to recipients via plasma transfusion. The relationship between clinical characteristics and antibody response to COVID-19 is not well defined. We investigated predictors of convalescent antibody production and quantified recipient antibody response in a convalescent plasma therapy clinical trial. MethodsMultivariable analysis of clinical and serological parameters in 103 confirmed COVID-19 convalescent plasma donors 28 days or more following symptom resolution was performed. Mixed effects regression models with piecewise linear trends were used to characterize serial antibody responses in 10 convalescent plasma recipients with severe COVID-19. FindingsMean symptom duration of plasma donors was 11.9{+/-}5.9 days and 7.8% (8/103) had been hospitalized. Antibody titers ranged from 0 to 1:3,892 (anti-receptor binding domain (RBD)) and 0 to 1:3,289 (anti-spike). Multivariable analysis demonstrated that higher anti-RBD and anti-spike titer were associated with increased age, hospitalization for COVID-19, fever, and absence of myalgia (all p<0.05). Fatigue was significantly associated with anti-RBD (p=0.03) but not anti-spike antibody titer (p=0.11). In pairwise comparison among ABO blood types, AB donors had higher anti-RBD titer than O negative donors (p=0.048) and higher anti-spike titer than O negative (p=0.015) or O positive (p=0.037) donors. Eight of the ten recipients were discharged, one remains on ECMO and one died on ECMO. No toxicity was associated with plasma transfusion. After excluding two ECMO patients and adjusting for donor antibody titer, recipient anti-RBD antibody titer increased on average 31% per day during the first three days post-transfusion (p=0.01) and anti-spike antibody titer by 40.3% (p=0.02). InterpretationAdvanced age, fever, absence of myalgia, fatigue, blood type and hospitalization were associated with higher convalescent antibody titer to COVID-19. Despite variability in donor titer, 80% of convalescent plasma recipients showed significant increase in antibody levels post-transfusion. A more complete understanding of the dose-response effect of plasma transfusion among COVID-19 patients is needed to determine the clinical efficacy of this therapy. Trial RegistrationNCT04340050 FundingDepartment of Surgery University of Chicago, National Institute of Allergy and Infectious Diseases (NIAID) Collaborative Influenza Vaccine Innovation Centers (CIVIC) contract 75N93019C00051

The Study of Preliminary Epidemiology for Burn Prevention

Burn injury is a common problem in our usual life, but many people don't still realize the physical, psychological and social effects of the burn patients. The purpose of this study is to find out what are the characteristics of burn patients and what are the risk factors for burns in order to prepare the specific prevention strategies in the future. In this study, data on 279 burn patients treated between October 2001 and December 2001 were analyzed. The typical burn victims of inpatients were young adults. They were mostly workers in production Dept. of the factory and residents of small and medium city. They were burn injured at work place just after the lunch break or before dawn, and due to flames with 30 - 70% burned body surface. They were working with their colleagues at that time. In case of outpatients, the typical burn victims were infants or toddlers. They were mostly middle or higher socioeconomic status in urban area, Seoul. They were burn injured in the kitchen during the dining time. They were burn injured due to scalds with less than 10% burned body surface and they were with their parents at that time. Epidemiological studies on burn patients should be performed continuously to prevent burn causes. For the burn prevention, it is necessary for implementing prevention strategies according to different subjects and need media campaigns for increasing public awareness on burn injuries.

A Case of Multiple Dermoid Cyst of the Floor of the Mouth / 대한이비인후과학회지

A multiple dermoid cyst is a rare tumor in the floor of the mouth. It presents as abnormal cystic development in the midline as a result of displaced or enclaved embryonic epithelium during the midline closure of the first and second bilateral branchial arches. Dermoid cyst is classified inot three categories according to its histological type; dermoid, epidermoid, and teratoma. The treatment of choice is complete surgical excision and prognosis is excellent. We present a recently encountered case of a multiple dermoid cyst in the floor of the mouth; the cyst was removed using the intraoral approach.

The Changes of the Generation of Superoxide Free Radical and the Activity of Antioxidant Enzymes after Streroid Therapy in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An intranasal topical and a systemic steroid therapy produce clinical improvement in patients with nasal polyps, but the mechanisms of their action are not clear. Recently, reactive oxygen species such as oxygen free radicals were identified as the potent toxic agents in various pathologic conditions including nasal polyps. The purposes of this study were to reveal the steroid effect on the generation of oxygen free radicals and exmaine the activities of various antioxidant enzymes in human nasal polyps. MATERIALS AND METHODS: Forty patients who received endoscopic sinus surgery due to chronic paranasal sinusitis with nasal polyps were classified into four groups; Group I included 10 specimens with no medication, group II included 10 specimens with oral steroid medication, Group III included 10 specimens with intranasal topical steroid therapy, group IV included 10 specimens with both oral and intranasal topical steroid therapy. We measured the generation of oxygen free radicals and activity of antioxidant enzymes, (SOD, GSH-Px, and CAT) and compared each group using electrophotometric analysis. RESULTS: The generation of oxygen free radicals were lowered in group II, III, and IV, compared to group I. Group IV showed the lowest level in the generation of oxygen free radicals. The activities of SOD, GSH-Px, and CAT, which are specific scavengers of oxygen free radicals, increased significantly in groups II, III, and IV (p<0.05). CONCLUSION: These results suggest that oxygen free radicals may play an important roles in the formation of nasal polyps. The mechanism of steroid action in the treatment of polyps may be explained in the decreased generation of oxygen free radicals and the increased activity of antioxidant enzymes in some ways.