A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia.
Ventura A Simonovich,Leandro Burgos Pratx,Paula Scibona,Maria Valeria Beruto,Marcelo Vallone,Carolina Vázquez,N. Savoy,Diego Giunta,Lucia Perez,Marisa Sanchez,Andrea V. Gamarnik,Diego Sebastian Ojeda,Diego Mario Santoro,Pablo J. Camino,Sebastian Antelo,Karina Rainero,Gabriela Vidiella,Erica A. Miyazaki,Wanda Cornistein,Omar A. Trabadelo,Fernando M. Ross,Mariano Spotti,Gabriel Funtowicz,Walter E. Scordo,Marcelo H. Losso,Inés Ferniot,Pablo E. Pardo,Eulalia Rodriguez,Pablo Rucci,Julieta Pasquali,Nora Fuentes,Mariano Esperatti,Gerardo A. Speroni,Esteban C. Nannini,Alejandra Matteaccio,Hernán G. Michelangelo,Dean Follmann,H. Clifford Lane,Waldo H. Belloso +38 more
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TLDR
No significant differences were observed in clinical status or overall mortality between patients treated with convalescent plasma and those who received placebo, and serious adverse events were similar in the two groups.Abstract:
Background Convalescent plasma is frequently administered to patients with Covid-19 and has been reported, largely on the basis of observational data, to improve clinical outcomes. Minimal data are available from adequately powered randomized, controlled trials. Methods We randomly assigned hospitalized adult patients with severe Covid-19 pneumonia in a 2:1 ratio to receive convalescent plasma or placebo. The primary outcome was the patient's clinical status 30 days after the intervention, as measured on a six-point ordinal scale ranging from total recovery to death. Results A total of 228 patients were assigned to receive convalescent plasma and 105 to receive placebo. The median time from the onset of symptoms to enrollment in the trial was 8 days (interquartile range, 5 to 10), and hypoxemia was the most frequent severity criterion for enrollment. The infused convalescent plasma had a median titer of 1:3200 of total SARS-CoV-2 antibodies (interquartile range, 1:800 to 1:3200]. No patients were lost to follow-up. At day 30 day, no significant difference was noted between the convalescent plasma group and the placebo group in the distribution of clinical outcomes according to the ordinal scale (odds ratio, 0.83 (95% confidence interval [CI], 0.52 to 1.35; P = 0.46). Overall mortality was 10.96% in the convalescent plasma group and 11.43% in the placebo group, for a risk difference of -0.46 percentage points (95% CI, -7.8 to 6.8). Total SARS-CoV-2 antibody titers tended to be higher in the convalescent plasma group at day 2 after the intervention. Adverse events and serious adverse events were similar in the two groups. Conclusions No significant differences were observed in clinical status or overall mortality between patients treated with convalescent plasma and those who received placebo. (PlasmAr ClinicalTrials.gov number, NCT04383535.).read more
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
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TL;DR: In this paper, a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV-2 in older adult patients within 72 hours after the onset of mild Covid-19 symptoms was conducted.
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References
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
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TL;DR: In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support.
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Covid-19
TL;DR: In ieder geval tijdens symptomatische fase waarna virus nog langer met PCR aantoonbaar kan zijn in de keel/feces.
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Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma.
Chenguang Shen,Zhaoqin Wang,Fang Zhao,Yang Yang,Jinxiu Li,Jing Yuan,Fuxiang Wang,Delin Li,Delin Li,Minghui Yang,Li Xing,Jinli Wei,Haixia Xiao,Haixia Xiao,Yan Yang,Jiuxin Qu,Ling Qing,Li Chen,Zhixiang Xu,Ling Peng,Yanjie Li,Haixia Zheng,Feng Chen,Kun Huang,Yujing Jiang,Dongjing Liu,Zheng Zhang,Yingxia Liu,Lei Liu +28 more
TL;DR: In this preliminary uncontrolled case series of 5 critically ill patients with COVID-19 and ARDS, administration of convalescent plasma containing neutralizing antibody was followed by improvement in their clinical status, and these observations require evaluation in clinical trials.
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