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《JAMA，6月3日，Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19》

  • 来源专题：COVID-19科研动态监测
  • 编译者： xuwenwhlib
  • 发布时间：2020-06-05

  • Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19
    A Randomized Clinical Trial
    Ling Li, MD, PhD1,2; Wei Zhang, MD3,4; Yu Hu, MD, PhD5; et alXunliang Tong, MD, PhD6; Shangen Zheng, MD7; Juntao Yang, PhD8; Yujie Kong, MD1,2; Lili Ren, PhD9,10; Qing Wei, MD11; Heng Mei, MD, PhD5; Caiying Hu, MD12; Cuihua Tao, MD13,14; Ru Yang, MD15; Jue Wang, MD1,2; Yongpei Yu, PhD16; Yong Guo, PhD17; Xiaoxiong Wu, MD18; Zhihua Xu, MD12,19; Li Zeng, MD3,20; Nian Xiong, MD12,21; Lifeng Chen, MD22; Juan Wang, MD11; Ning Man, MD23; Yu Liu, PhD1; Haixia Xu, MD1,2; E. Deng, MS1; Xuejun Zhang, MS1; Chenyue Li, MD1,2; Conghui Wang, PhD9; Shisheng Su, PhD17; Linqi Zhang, PhD24; Jianwei Wang, PhD9,10; Yanyun Wu, MD, PhD25; Zhong Liu, MD, PhD1,2
    Author Affiliations
    JAMA. Published online June 3, 2020. doi:10.1001/jama.2020.10044

    Abstract
    Importance  Convalescent plasma is a potential therapeutic option for patients with coronavirus disease 2019 (COVID-19), but further data from randomized clinical trials are needed.

    Objective  To evaluate the efficacy and adverse effects of convalescent plasma therapy for patients with COVID-19.

    Design, Setting, and Participants  Open-label, multicenter, randomized clinical trial performed in 7 medical centers in Wuhan, China, from February 14, 2020, to April 1, 2020, with final follow-up April 28, 2020. The trial included 103 participants with laboratory-confirmed COVID-19 that was severe (respiratory distress and/or hypoxemia) or life-threatening (shock, organ failure, or requiring mechanical ventilation). The trial was terminated early after 103 of a planned 200 patients were enrolled.

  • 原文来源：https://jamanetwork.com/journals/jama/article-abstract/2766943
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    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-04-09
    • Effectiveness of convalescent plasma therapy in severe COVID-19 patients View ORCID ProfileKai Duan, Bende Liu, Cesheng Li, View ORCID ProfileHuajun Zhang, Ting Yu, View ORCID ProfileJieming Qu, View ORCID ProfileMin Zhou, View ORCID ProfileLi Chen, Shengli Meng, Yong Hu, Cheng Peng, Mingchao Yuan, View ORCID ProfileJinyan Huang, Zejun Wang, Jianhong Yu, Xiaoxiao Gao, Dan Wang, View ORCID ProfileXiaoqi Yu, View ORCID ProfileLi Li, Jiayou Zhang, Xiao Wu, Bei Li, View ORCID ProfileYanping Xu, Wei Chen, Yan Peng, Yeqin Hu, Lianzhen Lin, Xuefei Liu, Shihe Huang, Zhijun Zhou, Lianghao Zhang, Yue Wang, Zhi Zhang, Kun Deng, Zhiwu Xia, Qin Gong, Wei Zhang, Xiaobei Zheng, Ying Liu, Huichuan Yang, Dongbo Zhou, Ding Yu, Jifeng Hou, Zhengli Shi, Saijuan Chen, Zhu Chen, Xinxin Zhang, and View ORCID ProfileXiaoming Yang PNAS first published April 6, 2020 https://doi.org/10.1073/pnas.2004168117 Abstract Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 109/L vs. 0.76 × 109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.
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  • 《JAMA，3月27日，Convalescent Plasma to Treat COVID-19 Possibilities and Challenges》
    • 来源专题：COVID-19科研动态监测
    • 编译者：zhangmin
    • 发布时间：2020-03-28
    • Convalescent Plasma to Treat COVID-19 Possibilities and Challenges John D. Roback, MD, PhD1; Jeannette Guarner, MD2 Author Affiliations Article Information JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4940 In this issue of JAMA, Shen et al report findings from a preliminary study of 5 severely ill patients with coronavirus disease 2019 (COVID-19) who were treated in the Shenzhen Third People's Hospital, China, using plasma from recovered individuals.1 All patients had severe respiratory failure and were receiving mechanical ventilation; 1 needed extracorporeal membrane oxygenation (ECMO) and 2 had bacterial and/or fungal pneumonia. Four patients without coexisting diseases received convalescent plasma around hospital day 20, and a patient with hypertension and mitral valve insufficiency received the plasma transfusion at day 10. The donor plasma had demonstrable IgG and IgM anti–SARS-CoV-19 antibodies and neutralized the virus in in vitro cultures.
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