tetano
Editor, Senior Moderator
Ann Intensive Care
. 2021 May 12;11(1):73.
doi: 10.1186/s13613-021-00867-9.
Convalescent plasma therapy and mortality in COVID-19 patients admitted to the ICU: a prospective observational study
Stefan Hatzl[SUP] 1 2 [/SUP], Florian Posch[SUP] 3 [/SUP], Nazanin Sareban[SUP] 4 [/SUP], Martin Stradner[SUP] 5 [/SUP], Konrad Rosskopf[SUP] 4 [/SUP], Alexander C Reisinger[SUP] 1 [/SUP], Philipp Eller[SUP] 1 [/SUP], Michael Sch?rghuber[SUP] 6 [/SUP], Wolfgang Toller[SUP] 6 [/SUP], Zdenka Sloup[SUP] 7 [/SUP], Florian Pr?ller[SUP] 7 [/SUP], Katharina G?tl[SUP] 8 [/SUP], Stefan Pilz[SUP] 9 [/SUP], Alexander R Rosenkranz[SUP] 10 [/SUP], Hildegard T Greinix[SUP] 2 [/SUP], Robert Krause[SUP] 11 [/SUP], Peter Schlenke[SUP] 4 [/SUP], Gernot Schilcher[SUP] 1 [/SUP]
Affiliations
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 paO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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.
Keywords: Acute respiratory distress syndrome; COVID-19; Convalescent plasma; ICU; Intensive care; Respiratory failure.
. 2021 May 12;11(1):73.
doi: 10.1186/s13613-021-00867-9.
Convalescent plasma therapy and mortality in COVID-19 patients admitted to the ICU: a prospective observational study
Stefan Hatzl[SUP] 1 2 [/SUP], Florian Posch[SUP] 3 [/SUP], Nazanin Sareban[SUP] 4 [/SUP], Martin Stradner[SUP] 5 [/SUP], Konrad Rosskopf[SUP] 4 [/SUP], Alexander C Reisinger[SUP] 1 [/SUP], Philipp Eller[SUP] 1 [/SUP], Michael Sch?rghuber[SUP] 6 [/SUP], Wolfgang Toller[SUP] 6 [/SUP], Zdenka Sloup[SUP] 7 [/SUP], Florian Pr?ller[SUP] 7 [/SUP], Katharina G?tl[SUP] 8 [/SUP], Stefan Pilz[SUP] 9 [/SUP], Alexander R Rosenkranz[SUP] 10 [/SUP], Hildegard T Greinix[SUP] 2 [/SUP], Robert Krause[SUP] 11 [/SUP], Peter Schlenke[SUP] 4 [/SUP], Gernot Schilcher[SUP] 1 [/SUP]
Affiliations
- PMID: 33978844
- DOI: 10.1186/s13613-021-00867-9
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 paO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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.
Keywords: Acute respiratory distress syndrome; COVID-19; Convalescent plasma; ICU; Intensive care; Respiratory failure.