Evaluation of the efficacy of immune plasma treatment in COVID-19 infected intensive care unit patients
Evaluación de la eficacia del tratamiento con plasma inmune en pacientes de la unidad de cuidados intensivos infectados por COVID-19
Emel Yıldız, Murat Emre Tokur, Bugra Özlem, Özlem Arık, Canan Balcı
Abstract
Introduction: Treatment approach in COVID-19 infection consists of antiviral, immunomodulatory, and supportive treatments. Convalescent plasma, immune plasma or hyperimmune plasma refers to the plasma that consisting of high titer polyclonal antibodies against the virus and are amidst the immunomodulatory treatments. Although it has been reported that immune plasma treatment of COVID-19 reduces hospital stay and mortality, the efficacy of immune plasma with COVID-19 infection is not clear yet. The present study aims to investigate the efficacy of immune plasma in patients who are followed up in the intensive care unit with the diagnosis of COVID-19.
Materials and methods: In this retrospective study, the patients who were hospitalized in the intensive care unit with the diagnosis of COVID-19 infection were divided into two groups: those who received IP treatment (Group 1; n=28) and those who did not (Group 2; n=25). The biochemical C -reactive protein, lactate-dehydrogenase, ferritin, D-dimer, total bilirubin, creatine levels, hematological parameters (Leukocyte, neutrophil, lymphocyte, platelet counts), clinical sepsis scores (SOFA, APACHE scores) and mortality rates of the patients were evaluated according to groups.
Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the presence of mechanical ventilation support and tracheostomy, comorbidities, laboratory values, C -reactive protein, SOFA, APACHE scores. The mortality rate was 61% in Group 1 and 52% in Group 2.
Conclusions: Our findings revealed that immune plasma treatment was not effective in recovery and decreasing the mortality rates in the COVID-19 infected intensive care unit patients. Further studies are needed to investigate the efficacy of administering immunomodulatory therapies on the outcome before the hyper inflammatory process starts.
Keywords
Resumen
Introducción: El enfoque de tratamiento en la infección por COVID-19 consiste en tratamientos antivirales, inmunomoduladores y de apoyo. El plasma de convalecencia, el plasma inmune o el plasma hiperinmune se refieren al plasma que consiste en anticuerpos policlonales de alto título contra el virus y se encuentra en medio de los tratamientos inmunomoduladores. Aunque se ha informado que el tratamiento con plasma inmune de COVID-19 reduce la estancia hospitalaria y la mortalidad, la eficacia del plasma inmune con la infección por COVID-19 aún no está clara. El presente estudio tiene como objetivo investigar la eficacia del plasma inmune en pacientes que son seguidos en la unidad de cuidados intensivos con el diagnóstico de COVID-19.
Materiales y métodos: En este estudio retrospectivo, los pacientes que fueron hospitalizados en la unidad de cuidados intensivos con el diagnóstico de infección por COVID-19 se dividieron en dos grupos: los que recibieron tratamiento IP (Grupo 1; n = 28) y los que lo hicieron. no (Grupo 2; n = 25). La proteína C reactiva bioquímica, lactato-deshidrogenasa, ferritina, dímero D, bilirrubina total, niveles de creatina, parámetros hematológicos (recuentos de leucocitos, neutrófilos, linfocitos, plaquetas), puntuaciones de sepsis clínica (puntuaciones SOFA, APACHE) y tasas de mortalidad de los pacientes fueron evaluados según grupos.
Resultados: No hubo diferencia estadísticamente significativa entre el Grupo 1 y el Grupo 2 en cuanto a la presencia de soporte ventilatorio mecánico y traqueotomía, comorbilidades, valores de laboratorio, proteína C reactiva, SOFA, puntajes APACHE. La tasa de mortalidad fue del 61% en el grupo 1 y del 52% en el grupo 2.
Conclusiones: Nuestros hallazgos revelaron que el tratamiento con plasma inmune no fue efectivo en la recuperación y la disminución de las tasas de mortalidad en los pacientes de la unidad de cuidados intensivos infectados por COVID-19. Se necesitan más estudios para investigar la eficacia de la administración de terapias inmunomoduladoras sobre el resultado antes de que comience el proceso hiperinflamatorio.
Palabras clave
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Submitted date:
11/20/2021
Reviewed date:
12/15/2021
Accepted date:
01/06/2022
Publication date:
01/06/2022
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