The new coronavirus disease(COVID-19)outbreak has challenged us to take unprecedented steps to bring this pandemic under control.In view of the urgency of this situation,convalescent plasma which was used in previous ...The new coronavirus disease(COVID-19)outbreak has challenged us to take unprecedented steps to bring this pandemic under control.In view of the urgency of this situation,convalescent plasma which was used in previous coronavirus outbreaks has emerged as one of the treatment options in this current pandemic.This is mainly due to the fact that convalescent plasma has been studied in a few case series with promising outcomes.In addition,on-going large clinical trials aimed to further evaluate the effectiveness,safety,and optimal dosage,duration and timing of administration of convalescent plasma are indeed revealing a certain level of promising results.Therefore,this article aims to provide an overview of possible mechanisms of actions of convalescent plasma,its benefits and its level of usage safeness by summarizing the existing evidence on the use of convalescent plasma in COVID-19 patients.展开更多
Severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and SARS-CoV-2 are three kinds of coronaviruses that are exceptionally pathogenic to humans via zoonotic i...Severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and SARS-CoV-2 are three kinds of coronaviruses that are exceptionally pathogenic to humans via zoonotic infections.The outbreaks of SARS-CoV and MERS-CoV,and SARS-CoV-2,to some extent,posed a severe threat to human health,daily activities as well as the economic status of many countries.When faced with these emerging viruses and no accessible vaccines and drugs,convalescent plasma(CP)is required as passive immunotherapy,since CP has the potential to neutralize and eliminate the virus from blood circulation.The sources of CP are individuals who have recovered from the viruses.Currently,CP is administered as emergency use and investigational treatment.Some studies have shown that CP is effective to treat infected individuals with viral pandemics such as influenza A,Ebola virus,SARS-CoV,and MERS-CoV.Moreover,following the deadly outbreak of SARS-CoV-2 in 2019,plenty of non-randomized clinical studies have been done on the effectiveness of CP for the treatment of Coronavirus Disease 2019(COVID-19),and most of these studies have indicated that CP therapy is promising and saved many critically-ill patients.Therefore,CP is a helpful immune therapeutic agent for the immediate response of such pandemics because of its clinical efficacy,immediate availability,cost-effectiveness,ease of production,delivery,and storage.This review aims to summarize the effectiveness of CP in the treatment of these three coronaviruses,i.e.SARS-CoV,MERS-CoV,and SARS-CoV-2.展开更多
BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking spe...BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.展开更多
Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019(COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems ...Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019(COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients.Case presentation: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration.Conclusion: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is a novel very contagious infection which was designated a pandemic in all countries of the world in April 2020.Its presentation varies from mild to severe infection,but t...BACKGROUND Coronavirus disease 2019(COVID-19)is a novel very contagious infection which was designated a pandemic in all countries of the world in April 2020.Its presentation varies from mild to severe infection,but the majority of infected patients have mild manifestations.Many therapeutic choices have been suggested to treat the infection,but none are fully effective.CASE SUMMARY Herein we present a 26-year-old woman with a twin pregnancy at 36 wk and one day gestation with confirmed COVID-19 who responded dramatically to convalescent plasma therapy(CPT)and Favipiravir.CONCLUSION Although this case report shows the efficacy of CPT in addition to usual medications used for COVID-19,there are many questions that need to be answered regarding dosage,para-clinical efficacy,side effects and combination therapy.展开更多
Novel coronavirus,SARS-CoV-2 is responsible for causing a pandemic that has affected individuals worldwide,over 192 million people and about 4.1 million people died so far.The spread is ongoing and the numbers are sti...Novel coronavirus,SARS-CoV-2 is responsible for causing a pandemic that has affected individuals worldwide,over 192 million people and about 4.1 million people died so far.The spread is ongoing and the numbers are still increasing.Numerous therapeutic approaches have been explored and developed during this pandemic.Immunotherapy with virus-specific antibodies in convalescent plasma(CP)has shown potential benefits for various pathogenic diseases.In many instances,it is the only available and safe management option for the COVID-19 patients.Here we describe two confirmed cases of COVID-19 from two different geographical areas that were managed with standard treatment modalities initially.Both of the patients were presented with high-grade fever,dry cough,and sore throat.Lab reports showed increased values of D-dimer,serum ferritin,leukocyte count(LC),Lactate dehydrogenase(LDH),and C-reactive protein(CRP).Chest X-ray showed bilateral infiltration(multifocal and bilateral ground-glass opacities and consolidations with peripheral and basal predominance),consistent with the previous reports on COVID-19 infection.The patients received conservative treatment according to the hospital's protocol.The convalescent plasma(from recovered patients)infusion was the last treatment given to both patients.After the convalescent plasma transfusion,both patients showed a reduction of viral load,an increase of anti-SARS-CoV-2 IgG and IgM antibodies,reduction in lung infiltration,with no adverse events.However,further randomized controlled trials are needed to investigate the full scope of safety and efficacy(both short and long-term)of convalescent plasma therapy for COVID-19 and other related infections.展开更多
Background:Due to the outbreak and rapid spread of coronavirus disease 2019(COVID-19),more than 160 million patients have become convalescents worldwide to date.Significant alterations have occurred in the gut and ora...Background:Due to the outbreak and rapid spread of coronavirus disease 2019(COVID-19),more than 160 million patients have become convalescents worldwide to date.Significant alterations have occurred in the gut and oral microbiome and metabonomics of patients with COVID-19.However,it is unknown whether their characteristics return to normal after the 1-year recovery.Methods:We recruited 35 confirmed patients to provide specimens at discharge and 1 year later,as well as 160healthy controls.A total of 497 samples were prospectively collected,including 219 tongue-coating,129 stool and 149 plasma samples.Tongue-coating and stool samples were subjected to 16S rRNA sequencing,and plasma samples were subjected to untargeted metabolomics testing.Results:The oral and gut microbiome and metabolomics characteristics of the 1-year convalescents were restored to a large extent but did not completely return to normal.In the recovery process,the microbial diversity gradually increased.Butyric acid-producing microbes and Bifidobacterium gradually increased,whereas lipopolysaccharideproducing microbes gradually decreased.In addition,sphingosine-1-phosphate,which is closely related to the inflammatory factor storm of COVID-19,increased significantly during the recovery process.Moreover,the predictive models established based on the microbiome and metabolites of patients at the time of discharge reached high efficacy in predicting their neutralizing antibody levels one year later.Conclusions:This study is the first to characterize the oral and gut microbiome and metabonomics in 1-year convalescents of COVID-19.The key microbiome and metabolites in the process of recovery were identified,and provided new treatment ideas for accelerating recovery.And the predictive models based on the microbiome and metabolomics afford new insights for predicting the recovery situation which benefited affected individuals and healthcare.展开更多
目的:利用微滴数字PCR(droplet digital PCR,DD-PCR)技术进行CpG岛甲基化表型(CpG island methylation phenotype,CIMP)结直肠癌分型,并探讨以血浆游离DNA进行CIMP分型的可行性。方法:收集2008到2012年在长海医院行结直肠癌手术的患者21...目的:利用微滴数字PCR(droplet digital PCR,DD-PCR)技术进行CpG岛甲基化表型(CpG island methylation phenotype,CIMP)结直肠癌分型,并探讨以血浆游离DNA进行CIMP分型的可行性。方法:收集2008到2012年在长海医院行结直肠癌手术的患者216例,抽提肿瘤组织DNA和血浆游离DNA,重亚硫酸盐处理后,利用DD-PCR进行CIMP分型。CIMP分型选用CACNA1G、IGF2、NEUROG1、RUNX3、SOCS1五个基因的甲基化位点,利用免疫组织化学技术(IHC)检测P53突变情况,以巢式PCR测序方法检测K-RAS和BRAF突变。结果:216例肿瘤中17例(7.9%)存在BRAF突变,96例(44.4%)存在K-RAS突变和112例(51.9%)P53-IHC(+)。31.5%(68/216)的结直肠癌为CIMP(+)(5个基因位点中高甲基化位点数目≥3),82.3%(14/17)的BRAF突变属于CIMP(+),而只有9.4%(9/96)的K-RAS突变和7.1%(8/112)的P53突变属于CIMP(+)。除了K-RAS,BRAF和P53突变外,同CIMP(-)结直肠癌相比,CIMP(+)肿瘤还具有独特的临床病理特征:肿瘤更易发生在结直肠的近端位置,黏液性癌比例偏高,分化程度较高,CIMP(+)患者生存时间显著短于CIMP(-)患者。利用血浆游离DNA进行分型和利用肿瘤组织进行分型的一致性为93.4%、灵敏度为87.2%、特异性为100%。结论:CIMP(+)结直肠癌具有独特的临床病理特征,且预后较差;在缺乏肿瘤组织的情况下,利用DD-PCR对血浆游离DNA进行CIMP分型是可行的。展开更多
基金financially supported by Taylor’s University Emerging Grant(TRGS/ERFS/2/2018/SBS/016)Monash Global Asia in the 21st Century(GA21)research grants(GA-HW-19-L01&GA-HW-19-S02)Fundamental Research Grant Scheme(FRGS/1/2019/WAB09/MUSM/02/1&FRGS/1/2019/SKK08/TAYLOR/02/2)
文摘The new coronavirus disease(COVID-19)outbreak has challenged us to take unprecedented steps to bring this pandemic under control.In view of the urgency of this situation,convalescent plasma which was used in previous coronavirus outbreaks has emerged as one of the treatment options in this current pandemic.This is mainly due to the fact that convalescent plasma has been studied in a few case series with promising outcomes.In addition,on-going large clinical trials aimed to further evaluate the effectiveness,safety,and optimal dosage,duration and timing of administration of convalescent plasma are indeed revealing a certain level of promising results.Therefore,this article aims to provide an overview of possible mechanisms of actions of convalescent plasma,its benefits and its level of usage safeness by summarizing the existing evidence on the use of convalescent plasma in COVID-19 patients.
文摘Severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and SARS-CoV-2 are three kinds of coronaviruses that are exceptionally pathogenic to humans via zoonotic infections.The outbreaks of SARS-CoV and MERS-CoV,and SARS-CoV-2,to some extent,posed a severe threat to human health,daily activities as well as the economic status of many countries.When faced with these emerging viruses and no accessible vaccines and drugs,convalescent plasma(CP)is required as passive immunotherapy,since CP has the potential to neutralize and eliminate the virus from blood circulation.The sources of CP are individuals who have recovered from the viruses.Currently,CP is administered as emergency use and investigational treatment.Some studies have shown that CP is effective to treat infected individuals with viral pandemics such as influenza A,Ebola virus,SARS-CoV,and MERS-CoV.Moreover,following the deadly outbreak of SARS-CoV-2 in 2019,plenty of non-randomized clinical studies have been done on the effectiveness of CP for the treatment of Coronavirus Disease 2019(COVID-19),and most of these studies have indicated that CP therapy is promising and saved many critically-ill patients.Therefore,CP is a helpful immune therapeutic agent for the immediate response of such pandemics because of its clinical efficacy,immediate availability,cost-effectiveness,ease of production,delivery,and storage.This review aims to summarize the effectiveness of CP in the treatment of these three coronaviruses,i.e.SARS-CoV,MERS-CoV,and SARS-CoV-2.
基金Medical Collaborative Science and Technology Innovation Research Project of Science and Technology Commission of Beijing,No.Z181100001918013Nanchang Science and Technology Bureau,No.20203306.
文摘BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.
基金supported by the Key Foundation of Wuhan Huoshenshan Hospital (2020 [18])Key Research&Development Program of Jiangsu Province (BE2018713)+3 种基金Medical Innovation Project of Logistics Service (18JS005)the Foundation of Jiangsu Population Association (JSPA2019017)Medical Science and Technology Development FoundationNanjing Department of Health (YKK18179)。
文摘Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019(COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients.Case presentation: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration.Conclusion: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is a novel very contagious infection which was designated a pandemic in all countries of the world in April 2020.Its presentation varies from mild to severe infection,but the majority of infected patients have mild manifestations.Many therapeutic choices have been suggested to treat the infection,but none are fully effective.CASE SUMMARY Herein we present a 26-year-old woman with a twin pregnancy at 36 wk and one day gestation with confirmed COVID-19 who responded dramatically to convalescent plasma therapy(CPT)and Favipiravir.CONCLUSION Although this case report shows the efficacy of CPT in addition to usual medications used for COVID-19,there are many questions that need to be answered regarding dosage,para-clinical efficacy,side effects and combination therapy.
文摘Novel coronavirus,SARS-CoV-2 is responsible for causing a pandemic that has affected individuals worldwide,over 192 million people and about 4.1 million people died so far.The spread is ongoing and the numbers are still increasing.Numerous therapeutic approaches have been explored and developed during this pandemic.Immunotherapy with virus-specific antibodies in convalescent plasma(CP)has shown potential benefits for various pathogenic diseases.In many instances,it is the only available and safe management option for the COVID-19 patients.Here we describe two confirmed cases of COVID-19 from two different geographical areas that were managed with standard treatment modalities initially.Both of the patients were presented with high-grade fever,dry cough,and sore throat.Lab reports showed increased values of D-dimer,serum ferritin,leukocyte count(LC),Lactate dehydrogenase(LDH),and C-reactive protein(CRP).Chest X-ray showed bilateral infiltration(multifocal and bilateral ground-glass opacities and consolidations with peripheral and basal predominance),consistent with the previous reports on COVID-19 infection.The patients received conservative treatment according to the hospital's protocol.The convalescent plasma(from recovered patients)infusion was the last treatment given to both patients.After the convalescent plasma transfusion,both patients showed a reduction of viral load,an increase of anti-SARS-CoV-2 IgG and IgM antibodies,reduction in lung infiltration,with no adverse events.However,further randomized controlled trials are needed to investigate the full scope of safety and efficacy(both short and long-term)of convalescent plasma therapy for COVID-19 and other related infections.
基金sponsored by grants from the National Key Research and Development Program of China(2018YFC2000501)National Natural Science Foundation of China(U2004121,82070643,and U1904164)。
文摘Background:Due to the outbreak and rapid spread of coronavirus disease 2019(COVID-19),more than 160 million patients have become convalescents worldwide to date.Significant alterations have occurred in the gut and oral microbiome and metabonomics of patients with COVID-19.However,it is unknown whether their characteristics return to normal after the 1-year recovery.Methods:We recruited 35 confirmed patients to provide specimens at discharge and 1 year later,as well as 160healthy controls.A total of 497 samples were prospectively collected,including 219 tongue-coating,129 stool and 149 plasma samples.Tongue-coating and stool samples were subjected to 16S rRNA sequencing,and plasma samples were subjected to untargeted metabolomics testing.Results:The oral and gut microbiome and metabolomics characteristics of the 1-year convalescents were restored to a large extent but did not completely return to normal.In the recovery process,the microbial diversity gradually increased.Butyric acid-producing microbes and Bifidobacterium gradually increased,whereas lipopolysaccharideproducing microbes gradually decreased.In addition,sphingosine-1-phosphate,which is closely related to the inflammatory factor storm of COVID-19,increased significantly during the recovery process.Moreover,the predictive models established based on the microbiome and metabolites of patients at the time of discharge reached high efficacy in predicting their neutralizing antibody levels one year later.Conclusions:This study is the first to characterize the oral and gut microbiome and metabonomics in 1-year convalescents of COVID-19.The key microbiome and metabolites in the process of recovery were identified,and provided new treatment ideas for accelerating recovery.And the predictive models based on the microbiome and metabolomics afford new insights for predicting the recovery situation which benefited affected individuals and healthcare.
文摘目的:利用微滴数字PCR(droplet digital PCR,DD-PCR)技术进行CpG岛甲基化表型(CpG island methylation phenotype,CIMP)结直肠癌分型,并探讨以血浆游离DNA进行CIMP分型的可行性。方法:收集2008到2012年在长海医院行结直肠癌手术的患者216例,抽提肿瘤组织DNA和血浆游离DNA,重亚硫酸盐处理后,利用DD-PCR进行CIMP分型。CIMP分型选用CACNA1G、IGF2、NEUROG1、RUNX3、SOCS1五个基因的甲基化位点,利用免疫组织化学技术(IHC)检测P53突变情况,以巢式PCR测序方法检测K-RAS和BRAF突变。结果:216例肿瘤中17例(7.9%)存在BRAF突变,96例(44.4%)存在K-RAS突变和112例(51.9%)P53-IHC(+)。31.5%(68/216)的结直肠癌为CIMP(+)(5个基因位点中高甲基化位点数目≥3),82.3%(14/17)的BRAF突变属于CIMP(+),而只有9.4%(9/96)的K-RAS突变和7.1%(8/112)的P53突变属于CIMP(+)。除了K-RAS,BRAF和P53突变外,同CIMP(-)结直肠癌相比,CIMP(+)肿瘤还具有独特的临床病理特征:肿瘤更易发生在结直肠的近端位置,黏液性癌比例偏高,分化程度较高,CIMP(+)患者生存时间显著短于CIMP(-)患者。利用血浆游离DNA进行分型和利用肿瘤组织进行分型的一致性为93.4%、灵敏度为87.2%、特异性为100%。结论:CIMP(+)结直肠癌具有独特的临床病理特征,且预后较差;在缺乏肿瘤组织的情况下,利用DD-PCR对血浆游离DNA进行CIMP分型是可行的。
