持续大剂量恢复期血浆对快速进展新型冠状病毒肺炎病情的临床治疗效果

Clinical Effect of Continuous High-dose Convalescent Plasma Therapy for Rapidly Progressing COVID-19

目的探讨应用恢复期血浆以及不同剂量对快速进展新型冠状病毒肺炎(新冠肺炎)患者的治疗效果。方法分析2020年1月20日~2021年1月31日北京地坛医院应用恢复期血浆治疗快速进展新冠肺炎患者28例,通过倾向性评分匹配得到非恢复期血浆治疗组53例作为对照。根据应用恢复期血浆的剂量将治疗组分为:小剂量组(<1200 mL)、中剂量组(≥1200 mL,<2000 mL)及大剂量组(≥2000 mL)。观察组间病情恢复时间、临床改善时间、影像学炎症吸收时间及核酸转阴时间的差异。结果与非恢复期血浆治疗组相比,恢复期血浆治疗组患者疾病的病情恢复时间(P=0.004)、临床改善时间(P=0.006)以及影像学炎症吸收时间(P<0.001)均显著缩短。持续大剂量应用恢复期血浆组较中剂量组(P=0.002;P=0.044)及小剂量组(P<0.001;P=0.002)更有利于新冠肺炎患者的病情恢复和临床改善。结论持续大剂量恢复期血浆疗法能促进快速进展新冠肺炎患者的恢复并改善临床病情。

Objective To investigate the therapeutic effect of convalescent plasma at different doses against cases of rapidly-progressing COVID-19.Methods Twenty-eight cases of COVID-19 who were hospitalized in Beijing Ditan Hospital between January 20,2020 and January 31,2021 and treated with convalescent plasma were retrospectively investigated.By means of propensity score matching,28 patients in the convalescent plasma group and 53 patients in the non-convalescent plasma group were obtained.The treatment group was divided into the low-dose group(<1200mL),medium-dose group(≥1200mL,<2000mL)and high-dose group(≥2000mL)according to the doses of convalescent plasma.The difference in the recovery time,clinical improvement time,imaging inflammatory absorption time and nucleic acid negative conversion time was compared between these groups.Results Compared with the non-convalescent plasma group,the convalescent plasma group exhibited significantly reduced recovery time(P=0.004),clinical improvement time(P=0.006),and imaging inflammatory absorption time(P<0.001).Continuous high-dose of convalescent plasma contributed more to the recovery and clinical improvement of COVID-19 than the medium(P=0.002;P=0.044)and low dose(P<0.001;P=0.002).Conclusion For patients with rapidly-progressing COVID-19,continuous high-dose convalescent plasma therapy can promote recovery and clinical improvement.