Usefulness of convalescent plasma transfusion for the treatment of severely ill COVID-19 patients in Pakistan

摘要

Convalescent plasma(CP)?was utilized as potential therapy during COVID-19 pandemic in Pakistan. The study aimed at appraisal of CP transfusion safety and usefulness in COVID pneumonia. Single arm, MEURI study design of non-randomized open label trial was conducted in five centers. Patients?werecategorized as moderately severe, severe, and critical. The?primary endpoint?was a) improvement in clinical status and change in category of disease severity; secondary endpoint?was b) CP ability to halt disease progression to invasive ventilation. CP transfused to hospitalized patients. Statistical tests including median (interquartile ranges), Mann-Whitney U test, Fisher’s exact test using SPSS ver. 23, ANOVA and Chi-square test were applied for the analysis of results parameters before and after CP treatment. SOFA score?was applied for multiorgan failure in severe and critical cases. A total of 50 adult patients; median age 58.5?years (range: 29–92?years) received CP with infusion titers; median 1:320?U/mL (Interquartile range 1:80–1:320) between April 4 to May 5, 2020. The median time from onset of symptoms to enrollment in trial was 3 to 7?days with?shortness of breath?and lung infiltration as severity criterion. In 35 (70%) recipients, oxygen saturation improved from 80 to 95% within 72h, with resolution of lung infiltrates. Primary endpoint was?achieved in 44 (88%) recipients whereas secondary endpoint?was achieved in 42 (84%). No patient experienced severe adverse events. A high SOFA score (?7) correlated with deaths in severe and critical patients. Eight (16%) patients expired due to comorbidities; cardiac arrest in 2 (4%), multiorgan failure secondary to cytokine storm in 5 (10%) and ventilator associated complications in 1 (2%). CP transfusion can be used as a safe and useful treatment in moderately severe and severe patients. The trial registration number is NCT04352751 ( https://www.irct.ir/search/result?query=IRCT20200414047072N1 ). Trial Registration date is 28th April 2020.