COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体变化和核酸清除研究

Study on the changes of antibodies and nucleic acid clearance in patients with COVID-19 during the recovery period in the treatment of COVID-19

目的探讨使用COVID-19康复者恢复期血浆治疗COVID-19患者后体内抗体IgM、IgG的产生和病毒核酸转阴变化规律以及临床治疗效果,为特异性抗体治疗COVID-19提供依据。方法应用COVID-19康复者恢复期血浆治疗75例COVID-19住院患者为输血组,未进行输血治疗200例为未输血组,定时检测两组患者体内抗体IgM和IgG及核酸基因ORF1ab和N含量,并统计比对分析。结果(1)输血组患者输注血浆后体内抗体IgM和IgG含量(47.89±64.63、68.70±69.14)分别高于输血前抗体IgM和IgG含量(4.55±11.02、4.46±13.99)差异均有统计学意义(P<0.05);输血组出院时患者抗体IgM和IgG含量(47.89±64.63、68.70±69.14)较未输血组(17.33±16.26、43.41±35.61)均明显的提高(P<0.05);输血后中型、重型和危重型患者抗体IgM和IgG含量(45.63±54.19,63.69±85.75,28.80±35.54;55.15±59.09,99.6±79.49,57.21±52.50)均高于输血前(3.78±9.85,3.88±10.07,7.49±14.22;2.98±12.23,6.05±18.24,5.88±10.07)(P<0.05);并且中型抗体IgM(45.63±54.19)和重型IgM(63.69±85.75)含量均明显高于危重型患者抗体IgM(28.80±35.54)含量(P<0.05)。(2)输血组新型冠状病毒核酸基因ORF1ab和N清除率(61.33%)高于同期未输血组(26.50%)(P<0.005)。(3)输血组中型和重型患者住院天数[(24.00±8.68)d,(28.00±11.46)d]较未输血组[(31.00±6.33)d,(39.00±8.69)d]均明显缩短(P<0.05)。结论应用COVID-19康复者恢复期血浆治疗COVID-19患者,可明显提高重型和危重型患者体内抗体IgM和IgG含量、增强免疫功能、加快病毒清除及核酸转阴率。

Objective To explore the production of antibodies IgM and IgG in the body of patients with COVID-19 after treatment with convalescent plasma of convalescent patients with novel coronavirus,and the regularity of viral nucleic acid negative change and clinical treatment effect,so as to provide basis for specific antibody treatment of COVID-19.Method 75 cases of COVID-19 hospitalized patients were treated with plasma from convalescent patients of COVID-19 as the blood transfusion group,and 200 cases were not treated with blood transfusion as the non blood transfusion group.The contents of antibody IgM and IgG,nucleic acid gene ORF1ab and N in the two groups were detected regularly,and analyzed statistically.Result(1)The levels of antibody IgM and IgG(47.89±64.63,68.70±69.14)in the blood transfusion group after plasma transfusion were significantly higher than those before blood transfusion(4.55±11.02,4.46±13.99,respectively)(P<0.05);The levels of IgM and IgG in the blood transfusion group at discharge(47.89±64.63,68.70±69.14)were significantly higher than those in the non blood transfusion group(17.33±16.26,43.41±35.61)(P<0.05);The levels of IgM and IgG(45.63±54.19,63.69±85.75,28.80±35.54;55.15±59.09,99.6±79.49,57.21±52.50)in patients with rapidly developing type,severe type and critical type after blood transfusion were higher than those before blood transfusion(3.78±9.85,3.88±10.07,7.49±14.22;2.98±12.23,6.05±18.24,5.88±10.07)(P<0.05),In addition,the contents of rapidly developing IgM(45.63±54.19)and severe IgM(63.69±85.75)were significantly higher than those of critically ill patients(28.80±35.54)(P<0.05).(2)The clearance rate of ORF1ab and N gene in COVID-19 patients in blood transfusion group(61.33%)was significantly higher than that in non blood transfusion group(26.50%)in the same period(P<0.005).(3)The hospitalization days[(24.00±8.68)d,(28.00±11.46)d]of rapidly developing and severe patients in the blood transfusion group were significantly shorter than those in the non blood transfusion group[(31.00±6.33)d,(39.00±8.69)d](P<0.05).Conclusion The application of COVID-19 convalescent frozen plasma in the treatment of COVID-19 patients can significantly increase the content of antibody IgM and IgG,enhance immune function,speed up virus clearance and nucleic acid negative rate in severe and critical patients.