2019冠状病毒病患者输注康复者恢复期血浆疗效

Effect of transfusion convalescent recovery plasma in patients with coronavirus disease 2019

目的:评价2019冠状病毒病(coronavirus disease 2019,COVID-19)患者输注康复者恢复期血浆的疗效。方法:回顾性分析2020年2月1日至3月15日在南昌大学第一附属医院象湖院区重症医学科住院治疗的18名重型、危重型COVID-19患者的临床资料,并根据是否输注康复者恢复期血浆将患者分为实验组(输注康复者恢复期血浆者,n=6)和观察组(未输注康复者恢复期血浆者,n=12)。比较两组患者临床基本资料及预后指标,并进一步分析实验组患者输注康复者恢复期血浆前、后的血氧饱和度的动态变化,输注康复者恢复期血浆后48 h淋巴细胞绝对值的变化及严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)核酸检测结果是否转阴。结果:两组患者年龄、性别、血型等临床基本资料差异均无统计学意义(均P>0.05)。两组患者呼吸机撤机时间、体外膜氧合(extracorporeal membrane oxygenation,ECMO)撤机时间、体温恢复至正常时间及住院天数方面的差异均无统计学意义(均P>0.05)。实验组6名患者输注康复者恢复期血浆前、输注过程中、输注后各时间点(1,6,8,12,24,36,48 h)血氧饱和度均在90%以上,亦未见明显波动。实验组3位患者输注康复者恢复期血浆后48 h淋巴细胞绝对值较输注前升高,另3位患者淋巴细胞绝对值较输注前减少。实验组有5名患者输注康复者恢复期血浆后48 h SARS-CoV-2核酸检测结果转阴,转阴率为83.3%。结论:输注康复者恢复期血浆未影响COVID-19患者预后,能迅速中和COVID-19患者体内的SARS-CoV-2,降低SARS-CoV-2载量。

Objective:To evaluate curative effects of coronavirus disease 2019(COVID-19)patients by the transfusion of other convalescent plasma.Methods:Retrospective analysis of the clinical data of 18 patients with severe and critical COVID-19,who were hospitalized in the ICU of Xianghu Branch of the First Affiliated Hospital of Nanchang University from February 1 to March 15,2020.Patients were subdivided into an experimental group(n=6,who had transfused the plasma)and an observation group(n=12,who had no plasma transfusion).Basic clinical data and prognosis indexes of these two groups were compared.Moreover,for the experimental group,the dynamic changes of blood oxygen saturation before and after the transfusion,the changes of lymphocyte absolute value 48 hours after the transfusion,and the detection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid were analyzed.Results:There were no significant differences in age,gender,blood type and other basic clinical data between the two groups(all P>0.05).There were no significant differences in ventilator machine weaning time,extracorporeal membrane oxygenation(ECMO)weaning time,body temperature recovery to normal time,and hospitalization days between these two groups(all P>0.05).For the experimental group,before,during and after the convalescent plasma transfusion,the blood oxygen saturation of all 6 patients at all time(1,6,8,12,24,36,and 48 h)was more than 90%,and there was no significant fluctuation.There were 3 patients whose absolute value of lymphocyte was increased 48 hours after the transfusion,and the remaining was decreased.There were 5 patients whose SARS-CoV-2 nucleic acid detection turned negative 48 hours after the transfusion,accounting for 83.3%.Conclusion:Transfusion of convalescent plasma will not affect outcomesof COVID-19 patients,which can neutralize SARS-CoV-2 in patients and reduce the loading capacity of SARS-CoV-2.