Abstract
Objective
To assess the safety and efficacy of convalescent plasma (CP) transfusion in elderly people with moderate to severe coronavirus disease 2019 (COVID-19) living in a long-term care facility (LTCF).
Patients and Methods
Twenty-two consecutive elderly patients with COVID-19 infection living in an LTCF in Lombardy, Italy, who were given CP during May 15 to July 31, 2020, were enrolled in a prospective cohort study. Their clinical, instrumental, and laboratory parameters were assessed following the CP treatment. The overall mortality rate in this group was compared with that recorded in other LTCFs in Lombardy during the 3-month period from March to May 2020.
Results
Of the 22 patients enrolled, 68.2% (n=15) received 1 CP unit, 27.3% (n=6) received 2 units, and 4.5% (n=1) received 3 units. Of the CP units transfused, 76.7% (23/30) had a neutralizing antibody titer of 1:160 or greater. No adverse reactions were recorded during or after CP administration. Improvements in clinical, functional, radiologic, and laboratory parameters during the 14 days after CP transfusion were observed in all 19 patients who survived. Viral clearance was achieved in all patients by the end of follow-up (median, 66 days; interquartile range, 48-80 days). The overall mortality rate was 13.6% (3/22), which compared favorably with that in the control group (38.3% [281/733]; P=.02) and corresponded to a 65% reduction in mortality risk.
Conclusion
Early administration of CP with an adequate anti–severe acute respiratory syndrome coronavirus 2 antibody titer to elderly symptomatic patients with COVID-19 infection in an LTCF was safe and effective in eliminating the virus, restoring patients’ immunity, and blocking the progression of COVID-19 infection, thereby improving patients’ survival.
Trial Registration
ClinicalTrials.gov: NCT04569188.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, convalescent plasma, Coronavirus disease 2019, C-reactive protein, interleukin 6, polymerase chain reaction, number needed to treat, Long-term care facility, COVID-19coronavirus disease 2019, SARS-CoV-2severe acute respiratory syndrome coronavirus 2, CRPC-reactive protein, CPconvalescent plasma, FiO2fraction of inspired oxygen, fraction of inspired oxygen, IQRinterquartile range, interquartile range, PCRpolymerase chain reaction, IL-6interleukin 6, LTCFlong-term care facility, ISSItalian National Institute of Health, Italian National Institute of Health, NNTnumber needed to treat, NSnot significant, not significant, RESCUEReal-time Evaluation of Safety and Efficacy of Convalescent Plasma Units Transfused to Elderly Patients With COVID-19, Real-time Evaluation of Safety and Efficacy of Convalescent Plasma Units Transfused to Elderly Patients With COVID-19, 【초록키워드】 COVID-19, Treatment, Efficacy, coronavirus, Immunity, Infection, risk, progression, Italy, prospective cohort study, virus, improvement, Registration, survival, COVID-19 infection, Patient, Antibody titer, Follow-up, Care, moderate, Neutralizing antibody titer, administration, Adverse reaction, lombardy, Elderly patient, Safe, acute respiratory syndrome, control group, overall mortality, severe coronavirus disease, clearance, reduction in mortality, objective, effective, laboratory parameter, Result, greater, enrolled, radiologic, median, functional, were given, recorded, eliminating, were recorded, patients who survived, symptomatic patient, transfused, were assessed, with COVID-19, 【제목키워드】 COVID-19, Safety, elderly,