Timing of convalescent plasma therapy-tips from curing a 100-yearold COVID-19 patient using convalescent plasma treatment: A case report

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.

Convalescent plasma therapy in a pregnant COVID-19 patient with a dramatic clinical and imaging response: A case report

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.

Patients with Prolonged Positivity of SARS-CoV-2 RNA Benefit from Convalescent Plasma Therapy:A Retrospective Study

Convalescent plasma therapy has been implemented in a few cases of severe coronavirus disease 2019.No report about convalescent plasma therapy in treating patients with prolonged positivity of SARS-CoV-2 RNA has been published.In this study,we conducted a retrospective observational study in 27 patients with prolonged positivity of SARS-CoV-2 RNA,the clinical benefit of convalescent plasma therapy were analyzed.q RT-PCR test of SARS-CoV-2 RNA turned negative(B 7 days)in a part of patients(early negative group,n=15)after therapy,others(late negative group,n=12)turned negative in more than 7 days.Pulmonary imaging improvement was confirmed in 7 patients in early negative group and 8 in late negative group after CP therapy.Viral load decreased in early negative group compared with late negative group at day 3,5,7 after implementing convalescent plasma therapy.Patients in early negative group had a shorter median length of hospital stay.In conclusion,convalescent plasma therapy might help eliminate virus and shorten length of hospital stay in patients with prolonged positivity of SARS-CoV-2 RNA.

Utility of convalescent plasma for addressing the COVID-19 infection: brief review and case reports

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.

Argon plasma coagulation for superficial esophageal squamous-cell carcinoma in high-risk patients

AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to recurrence.RESULTS: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.

Non-Drug Therapy to Combat Coronavirus

Novel coronavirus is threatening the health of people all over the world and all possible treatment strategies are in urgent. The sensitive of virus to heat proposed temperature treatment as an effective method against coronavirus. Here, we proposed several non-drug therapies including far-infrared, thermal air, thermal oxygen, ozone, hydrogen therapy and plasma physical therapy for immediate clinical trial and implementation. Compared with the drug therapy, these methods are safe without side effects, the highest benefit-to-risk ratio, user-friendly, and low implementation costs. It is urgent and significant to start these non-drug therapeutic design and implementation as early as possible, to determine the safety and effectiveness of these therapeutic methods.

STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE THERAPY FOR TREATMENT OF EPIGASTRALGIA

In the present paper, the therapeutic effect of acupuncture in treatment of 42 cases of epigastralgia was observed using multiple objective indexes, including electrogastrogram (EGG), output of gastric acid and pepsase, plasma prostaglandin (PG) E and gastrin contents, the number and morphological structure of gastrin (G) cells of the antrum mucosa. These 42 cases included 18 cases of deficiency syndrome type, 13 excess syndrome type and 11 mixed type of deficiency and excess. Zhongwan (CV 12), Neiguan (PC 6) and Zusanli (ST 36) were punctured combined with other acupoints according to syndrome patterns. After treatment, 32 cases (76.19%) were cured, 6(14.29%) had remarkable improvement and 4 (9.52%) had improvement, with a cure plus markedly effective rate of 90.48%. Gastroscopic and EGG examination suggested that the function and structure of the stomach returned to normal after acupuncture. In addition, acupuncture stimulation had a bi directional regulative action on gastric acid secretion, gastrin content, EGG activity, etc. Conclusion: Acupuncture treatment has a good regulative action on gastric function and structure in epigastralgia patients.

Successful treatment of severe monkeypox case with advanced HIV infection using plasma from smallpoxvaccinated healthy population:A case report

Since the first reported case of monkeypox in the UK in May 2022,there has been an upward trend in monkeypox cases and a global outbreak.However,reports of severe cases are relatively limited.In this study,we report a case of severe monkeypox in a patient with HIV.The patient presented with skin lesions that started on his face and around the penis and persisted for several months.Throughout the course of the disease,he received systematic symp-tomatic supportive treatment,topical remedies,and special care for the rash.He also underwent cidofovir antiviral therapy and smallpox‐vaccinated healthy population‐derived plasma therapy in succession,with the condition ultimately showing improvement after plasma treatment.After more than 3 months of hospitalization,he fully recovered.To the best of our knowledge,this is the first reported use of smallpox‐vaccinated healthy population‐derived plasma in the treatment of severe monkeypox cases.

Update on hemolytic uremic syndrome:Diagnostic and therapeutic recommendations

Hemolytic uremic syndrome （HUS） is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and patho-genetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the comple-ment proteins are clearly involved in all types of thrombotic microangiopathy： typical HUS, atypical HUS and thrombotic thrombocytopenic purpura （TTP）. Fur-thermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic as-pects of this rare disease, examining both “traditional therapy” （including plasma therapy, kidney and kidney-liver transplantation） and “new therapies”. The latter include anti-Shiga-toxin antibodies and anti-C5 mono-clonal antibody “eculizumab”. Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TTP. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purifed, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recombinant complement-regulatory proteins are a potential future therapy.

Immunological aspects of COVID-19:What do we know?

The newly emerged coronavirus(severe acute respiratory syndrome coronavirus 2 SARS-CoV-2)and the disease that it causes coronavirus disease 2019(COVID-19)have changed the world we know.Yet,the origin and evolution of SARS-CoV-2 remain mostly vague.Many virulence factors and immune mechanisms contribute to the deteriorating effects on the organism during SARS-CoV-2 infection.Both humoral and cellular immune responses are involved in the pathophysiology of the disease,where the principal and effective immune response towards viral infection is the cell-mediated immunity.The clinical picture of COVID-19,which includes immune memory and reinfection,remains unclear and unpredictable.However,many hopes are put in developing an effective vaccine against the virus,and different therapeutic options have been implemented to find effective,even though not specific,treatment to the disease.We can assume that the interaction between the SARS-CoV-2 virus and the individual's immune system determines the onset and development of the disease significantly.

COVID-19 Vaccine

A number of companies have announced the vaccines for COVID-19 pandemic that has caused extreme poverty, famine, and more than a billion people have lost livelihood all across the globe. Mass production of vaccine Sputnik V is underway at different locations to inoculate population in Russia, Philippines, Vietnam, Brazil, Saudi Arab, and United Arab Emirates (UAE), and India. mRNA based vaccine of Pfizer-BioNTech after passing phase 2 trial is ready for testing on thousands of volunteers. Oxford University-AstraZeneca vaccine is also under phase 3 trial in US, Brazil, and India. In September, Novavax Inc.’s vaccine will be ready for phase 3 trial. By early next year, two billions of doses will be ready of Novavax. Moderna Therapeutics conducting vaccine trial on 30 thousands volunteers, results will be known soon. Hundreds of thousand volunteers have registered already for vaccination in US and other parts of the world. SinoVac Biotech Ltd. has prepared a vaccine “CoronaVac” and inoculating volunteers in Indonesia and Brazil. CanSino Biologics Inc. in phase 2 trial on 508 volunteers found a satisfactory immune response to COVID-19 virus. Apart from vaccine preparation and availability, we provided data for therapy and treatment for COVID-19 and transmission and stability aspect of COVID-19 SARS-Cov-2 virus. The data and results presented in this article are very important and useful in containing, treating, and eliminating the pandemic COVID-19.

Pandemic COVID-19:Current status and challenges of antiviral therapies

The pandemic COVID-19,caused by a new coronavirus SARS-CoV-2 infection,has infected over 12 million individuals and caused more than 55,200 death worldwide.Currently,there is no specific drug to treating this disease.Here we summarized the mechanisms of antiviral therapies and the clinic findings from different countries.Antiviral chemotherapies have been conducted by in multiple cohorts in different counties.Although FDA has fast approved remdesivir for treating COVID-19,it only speeds up recovery from COVID-19 with mildly reduced mortality.The chloroquine was suggested a potential drug against SARS-CoV-2 infection due to its in vitro antiviral effects,it is imperative high-quality data from worldwide clinical trials are necessitated for an approved therapy.In terms of hydroxychloroquine(HCQ)therapy,although WHO has stopped all the clinic trials due to its strong side-effects in COVID patients,large scale clinical trials with a long-term outcome follow-up may warrant HCQ and azithromycin combination in combating the virus.Convalescent plasma(CP)therapy suggested its safety use in SARS-CoV-2 infection;but both CP immunotherapy and NK cellular therapy must be manufactured and utilized according to scrupulous ethical and controlled conditions to guarantee a possible role of these products of human origin.Further research should be conducted to define the exact mechanism of SARS-CoV-2 pathogenesis,suitable animal models or ex vivo human lung tissues aid in studying replication,transmission and spread of the novel viruses,thereby facilitating highly effective therapies.