Open AccessConvalescent plasma in Severe/ Critically Ill COVID-19 patients; impact of time and mechanical ventilation
Author(s) -
Hassan Abolghasemi,
Abdol Majid Cheraghali,
Abbasali. Imani-Fooladi,
Peyman Eshghi,
Mokhtar Tazik,
Nariman Sadri,
Farzaneh BoloukiMoghaddam,
Mohammad Rezapour,
Sina Imanizadeh,
Matin Maeini Maleki,
Mohammad Hosein Ranjkesh,
Hoshyar Maghsoudi,
Mahtab Maghsoodlu,
NasimSadat HosseiniDivkolaye,
Ramezan Jafari,
Behzad Einollahi,
Mohamad Nikpouraghdam,
Zahra Soleimani,
Ali Bahramifar,
Hassan Goodarzi,
Nematollah JoneidiJafari,
Mojtaba Sepandi,
Ali Ghazvini,
Seyed Mohammad Javad Hoseini,
Mohammad Hadi Radfar
Publication year - 2021
Publication title -
iranian red crescent medical journal
Language(s) - English
Resource type - Journals
ISSN - 2074-1804
DOI - 10.32592/ircmj.2021.23.9.802
Subject(s) - medicine , mechanical ventilation , septic shock , respiratory failure , intensive care unit , fraction of inspired oxygen , blood transfusion , anesthesia , intensive care medicine , sepsis
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients.Methods: We investigated the efficacy and safety of CP transfusion in 50 consecutive COVID-19 patients with severe/ critically ill disease. Severe disease was defined as having at least one of the following: shortness of breath, respiratory frequency ≥ 20/min, blood oxygen saturation ≤ 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within recent 24-48 hours. Critically ill disease was considered as intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as secondary outcome.Results: Of 50 consecutive patients, 21 were on mechanical ventilation at time of CP transfusion. Totally, 32 patients (64%) survived 30 days after CP transfusion. Survival rate was 74% and 44% in patients who received CP <7 and ≥7 days of admission, respectively. While 92% of patients without mechanical ventilation survived, survival was 29% in patients on mechanical ventilation. CT scan score and some other clinical features were improved. No adverse effects were observed.Conclusion: CP transfusion is a safe and effective treatment in COVID-19 patients with severe/ critically ill disease. The best outcome can be achieved in patients who are not on mechanical ventilation especially early in the disease course.