ABSTRACT
BACKGROUND: Convalescent plasma (CP) became a prominent treatment in the early stages of the SARS-CoV-2 pandemic. In Argentina, a randomized clinical trial was executed to compare the use of CP in inpatients with severe COVID-19 pneumonia versus placebo. No differences in clinical outcomes or overall mortality between groups were observed. We conducted a cohort study in outpatients enrolled in the trial to describe long-term antibody titer variations between CP and placebo recipients. METHODS: Patients' total SARS-CoV-2 IgG antibodies against spike protein were collected 3, 6 and 12 months after hospital discharge from August 2020 to December 2021. In addition, reinfections, deaths and vaccination status were retrieved. Statistical analysis was performed using antibody geometric mean titers (GMT). All estimations were made considering the date of the trial infusion (placebo or CP) as time 0. RESULTS: From the 93 patients included in the follow-up, 64 had received CP and 29 placebo. We excluded all 12-month measurements because they were collected after the patients' vaccination date. At 90 days post-infusion, patients had an antibody GMT of 8.1 (IQR 7.4-8.1) in the CP group and 8.8 (IQR 8.1-9.1) in the placebo group. At 180 days, both groups had a GMT of 8.1 (IQR 7.4-8.1). No statistical differences in GMT were found between CP and placebo groups at 90 days (p = 0.12) and 180 days (p = 0.25). No patients registered a new COVID-19 infection; one died in the CP group from an ischemic stroke. CONCLUSIONS: No differences were observed in long-term antibody titers in unvaccinated patients that received CP or placebo after severe COVID-19 pneumonia.
Subject(s)
COVID-19 , Humans , COVID-19/therapy , COVID-19/etiology , SARS-CoV-2 , Cohort Studies , Immunization, Passive/adverse effects , COVID-19 Serotherapy , Antibodies, ViralABSTRACT
BACKGROUND: Current evidence regarding COVID-19 convalescent plasma (CCP) transfusion practices is limited and heterogeneous. We aimed to determine the impact of the use of CCP transfusion in patients with previous circulating neutralizing antibodies (nAbs) in COVID-19. METHODS: Prospective cohort including 102 patients with COVID-19 transfused with ABO compatible CCP on days 0-2 after enrollment. Clinical status of patients was assessed using the adapted World Health Organization (WHO) ordinal scale on days 0, 5, and 14. The nAbs titration was performed using the cytopathic effect-based virus neutralization test with SARS-CoV-2 (GenBank MT126808.1). The primary outcome was clinical improvement on day 14, defined as a reduction of at least two points on the adapted WHO ordinal scale. Secondary outcomes were the number of intensive care unit (ICU)-free days and the number of invasive mechanical ventilation-free days. RESULTS: Both nAbs of CCP units transfused (p < 0.001) and nAbs of patients before CCP transfusions (p = 0.028) were associated with clinical improvements by day 14. No significant associations between nAbs of patients or CCP units transfused were observed in the number of ICU or mechanical ventilation-free days. Administration of CCP units after 10 days of symptom onset resulted in a decrease in ICU-free days (p < 0.001) and mechanical ventilation-free days (p < 0.001). CONCLUSION: Transfusion of high titer nAbs CCP units may be a determinant in clinical strategies against COVID-19. We consider these data as useful parameters to guide future CCP transfusion practices.
Subject(s)
Antibodies, Neutralizing/blood , COVID-19/therapy , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing/immunology , Antibodies, Viral/blood , Antibodies, Viral/immunology , Blood Donors , COVID-19/blood , COVID-19/immunology , Cohort Studies , Female , Humans , Immunization, Passive/methods , Male , Middle Aged , SARS-CoV-2/immunology , COVID-19 SerotherapyABSTRACT
Resumen Lugar: Fundación Cardioinfantil-instituto de Cardiología (FCI), Bogotá, Colombia. Objetivo: determinar los factores asociados con eventos adversos transfusionales (EAT) con plasma fresco congelado (PFC) en la FCI durante los años 2008-2010. Metodología: estudio de casos y controles, en relación 1:3. Pacientes mayores de 18 años transfundidos con PFC en la FCI durante los años 2008-2010. Los casos fueron identificados a partir del registro de EAT de la FCI. Los controles recibieron transfusión de PFC y no presentaron evento adverso. Resultados: el promedio de edad de los casos fue menor que el de los controles (52.4 vs. 60.5 años, p=0.001). los eventos adversos de tipo alérgico fueron los más frecuentes, aumentaron con la utilización de unidades provenientes de otros bancos de sangre (0.7 vs. 0.0 unidades, p=0.003), cuando el donante fue de sexo femenino (2.5 vs. 1.4 donantes de sexo femenino, p=0.11) y con la paridad aumentada de dichas donantes (4.0 vs. 2.6 partos, p=0.04). La sepsis (or: 0.1, iC95%:0.01-0.87, p=0.015) y la diabetes (or: 0.9, iC95%:0.01-0.54, p=0.003) se comportaron como factores protectores para el desarrollo de los eventos adversos de tipo alérgico. Conclusiones: los EAT con PFC están asociados con donantes mujeres, multíparas y unidades provenientes de bancos de sangre no institucionales. su incidencia podría disminuir al no permitir donantes mujeres con más de cuatro embarazos. (Acta Med Colomb 2013; 38: 127-131).
Abstract Place: Fundación Cardio-infantil (FCI), Bogotá, Colombia. Objective: to determine factors associated with transfusion-associated adverse events with fresh frozen plasma (FFP) in the FCI during the years 2008-2010. Methodology: case-control study, in ratio 1:3. Patients over 18 years transfused with FFP in the FCI during the years 2008-2010. Cases were identified from the FCI transfusion -associated adverse events registry. Controls received FFP transfusion and had no adverse events. Results: the average age of cases was lower than that of controls (52.4 vs. 60.5 years, p = 0.001). The adverse events were the most frequent ones, and increased with the use of units from other blood banks (0.7 vs. 0.0 units, p = 0.003), when the donor was female (2.5 vs. 1.4 female donors, p = 0.11) and with the increased parity of such donors (4.0 vs. 2.6 deliveries, p = 0.04). Sepsis (or: 0.1, 95% Ci:0,01-0, 87, p = 0.015) and diabetes (or: 0.9, 95% Ci:0,01-0, 54, p = 0.003) behaved as protective factors for the development of adverse allergic type events. Conclusions: the transfusion-associated adverse events with PFC are associated with female multiparous donors and with blood units provided by non-institutional blood banks. Its incidence could diminish by not allowing female donors with more than four pregnancies. (Acta Med Colomb 2013; 38: 127-131).
Subject(s)
Humans , Male , Female , Middle Aged , Plasma , Blood Banks , Case-Control Studies , Records , Drug-Related Side Effects and Adverse ReactionsABSTRACT
The article desribes the indications for blood and blood component transfusion in large animals, also tracing coments on choosing a blood donor and blood compatibility testing, blood collection, the transfusion and possible adverse reactions.
O artigo descreve as indicações para a transfusão de sangue e seus derivados em grandes animais, abordando também a escolha de doadores e testes de compatibilidade sangûÃnea, a colheita de sangue, a transfusão propriamente dita e possÃveis reações adversas.
ABSTRACT
The article desribes the indications for blood and blood component transfusion in large animals, also tracing coments on choosing a blood donor and blood compatibility testing, blood collection, the transfusion and possible adverse reactions.
O artigo descreve as indicações para a transfusão de sangue e seus derivados em grandes animais, abordando também a escolha de doadores e testes de compatibilidade sangüínea, a colheita de sangue, a transfusão propriamente dita e possíveis reações adversas.