tetano
Editor, Senior Moderator
J Clin Med
. 2021 May 14;10(10):2113.
doi: 10.3390/jcm10102113.
Convalescent Plasma Efficacy in Life-Threatening COVID-19 Patients Admitted to the ICU: A Retrospective Cohort Study
Mohamed Abuzakouk[SUP] 1 2 [/SUP], Khaled Saleh[SUP] 3 [/SUP], Manuel Algora[SUP] 2 4 [/SUP], Ahmad Nusair[SUP] 5 [/SUP], Jawahir Alameri[SUP] 6 [/SUP], Fatema Alshehhi[SUP] 6 [/SUP], Sara Alkhaja[SUP] 6 [/SUP], Mohamed Badr[SUP] 3 [/SUP], Khaled Abdallah[SUP] 3 [/SUP], Bruno De Oliveira[SUP] 3 [/SUP], Ashraf Nadeem[SUP] 3 [/SUP], Yeldho Varghese[SUP] 3 [/SUP], Dnyaseshwar Munde[SUP] 3 [/SUP], Shameen Salam[SUP] 3 [/SUP], Baraa Abduljawad[SUP] 3 [/SUP], Hussam Elkambergy[SUP] 3 [/SUP], Ali Wahla[SUP] 2 [/SUP], Ahmed Taha[SUP] 3 [/SUP], Jamil Dibu[SUP] 3 [/SUP], Ahmed Bayrlee[SUP] 3 [/SUP], Fadi Hamed[SUP] 3 [/SUP], Laila AbdelWareth[SUP] 4 [/SUP], Nadeem Rahman[SUP] 3 [/SUP], Jorge Guzman[SUP] 3 [/SUP], Jihad Mallat[SUP] 2 3 7 [/SUP]
Affiliations
Abstract
(1) Background: There are limited data regarding the efficacy of convalescent plasma (CP) in critically ill patients admitted to the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). We aimed to determine whether CP is associated with better clinical outcome among these patients. (2) Methods: A retrospective single-center study including adult patients with laboratory-confirmed SARS-CoV-2 infection admitted to the ICU for acute respiratory failure. The primary outcome was time to clinical improvement, within 28 days, defined as patient discharged alive or reduction of 2 points on a 6-point disease severity scale. (3) Results: Overall, 110 COVID-19 patients were admitted. Thirty-two patients (29%) received CP; among them, 62.5% received at least one CP with high neutralizing antibody titers (≥1:160). Clinical improvement occurred within 28 days in 14 patients (43.7%) of the CP group vs. 48 patients (61.5%) in the non-CP group (hazard ratio (HR): 0.75 (95% CI: 0.41-1.37), p = 0.35). After adjusting for potential confounding factors, CP was not independently associated with time to clinical improvement (HR: 0.53 (95% CI: 0.23-1.22), p = 0.14). Additionally, the average treatment effects of CP, calculated using the inverse probability weights (IPW), was not associated with the primary outcome (-0.14 days (95% CI: -3.19-2.91 days), p = 0.93). Hospital mortality did not differ between CP and non-CP groups (31.2% vs. 19.2%, p = 0.17, respectively). Comparing CP with high neutralizing antibody titers to the other group yielded the same findings. (4) Conclusions: In this study of life-threatening COVID-19 patients, CP was not associated with time to clinical improvement within 28 days, or hospital mortality.
Keywords: SARS-CoV-2; convalescent plasma; critically ill; intensive care unit; life-threatening COVID-19; mechanical ventilation; neutralizing antibody.
. 2021 May 14;10(10):2113.
doi: 10.3390/jcm10102113.
Convalescent Plasma Efficacy in Life-Threatening COVID-19 Patients Admitted to the ICU: A Retrospective Cohort Study
Mohamed Abuzakouk[SUP] 1 2 [/SUP], Khaled Saleh[SUP] 3 [/SUP], Manuel Algora[SUP] 2 4 [/SUP], Ahmad Nusair[SUP] 5 [/SUP], Jawahir Alameri[SUP] 6 [/SUP], Fatema Alshehhi[SUP] 6 [/SUP], Sara Alkhaja[SUP] 6 [/SUP], Mohamed Badr[SUP] 3 [/SUP], Khaled Abdallah[SUP] 3 [/SUP], Bruno De Oliveira[SUP] 3 [/SUP], Ashraf Nadeem[SUP] 3 [/SUP], Yeldho Varghese[SUP] 3 [/SUP], Dnyaseshwar Munde[SUP] 3 [/SUP], Shameen Salam[SUP] 3 [/SUP], Baraa Abduljawad[SUP] 3 [/SUP], Hussam Elkambergy[SUP] 3 [/SUP], Ali Wahla[SUP] 2 [/SUP], Ahmed Taha[SUP] 3 [/SUP], Jamil Dibu[SUP] 3 [/SUP], Ahmed Bayrlee[SUP] 3 [/SUP], Fadi Hamed[SUP] 3 [/SUP], Laila AbdelWareth[SUP] 4 [/SUP], Nadeem Rahman[SUP] 3 [/SUP], Jorge Guzman[SUP] 3 [/SUP], Jihad Mallat[SUP] 2 3 7 [/SUP]
Affiliations
- PMID: 34068847
- DOI: 10.3390/jcm10102113
Abstract
(1) Background: There are limited data regarding the efficacy of convalescent plasma (CP) in critically ill patients admitted to the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). We aimed to determine whether CP is associated with better clinical outcome among these patients. (2) Methods: A retrospective single-center study including adult patients with laboratory-confirmed SARS-CoV-2 infection admitted to the ICU for acute respiratory failure. The primary outcome was time to clinical improvement, within 28 days, defined as patient discharged alive or reduction of 2 points on a 6-point disease severity scale. (3) Results: Overall, 110 COVID-19 patients were admitted. Thirty-two patients (29%) received CP; among them, 62.5% received at least one CP with high neutralizing antibody titers (≥1:160). Clinical improvement occurred within 28 days in 14 patients (43.7%) of the CP group vs. 48 patients (61.5%) in the non-CP group (hazard ratio (HR): 0.75 (95% CI: 0.41-1.37), p = 0.35). After adjusting for potential confounding factors, CP was not independently associated with time to clinical improvement (HR: 0.53 (95% CI: 0.23-1.22), p = 0.14). Additionally, the average treatment effects of CP, calculated using the inverse probability weights (IPW), was not associated with the primary outcome (-0.14 days (95% CI: -3.19-2.91 days), p = 0.93). Hospital mortality did not differ between CP and non-CP groups (31.2% vs. 19.2%, p = 0.17, respectively). Comparing CP with high neutralizing antibody titers to the other group yielded the same findings. (4) Conclusions: In this study of life-threatening COVID-19 patients, CP was not associated with time to clinical improvement within 28 days, or hospital mortality.
Keywords: SARS-CoV-2; convalescent plasma; critically ill; intensive care unit; life-threatening COVID-19; mechanical ventilation; neutralizing antibody.