Abstract

Humans infected with SARS-CoV-2 may develop COVID-19, which manifests across a wide spectrum of clinical severity ranging from mild upper respiratory tract illnesses to diffuse viral pneumonia, causing acute respiratory failure. Many therapies have been tested for their efficacy in treating COVID-19. Controversy surrounds convalescent plasma transfusions as an effective treatment for COVID-19. This study discusses the efficacy of this treatment on COVID-19 patients. Electronic medical record data were collected from patients diagnosed with COVID-19, from November 2020 to August 2021, in the Galilee Medical Center’s COVID-19 departments. Epidemiological, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression and discriminant analyses were used to identify and validate the correlation between convalescent treatment and either death or time to negative PCR and hospitalization length. The study population included 270 patients, 100 of them treated with convalescent plasma. The results show that convalescent plasma therapy significantly prevented mortality in moderate patients, reduced hospitalization length and time to negative PCR. Additionally, high BMI, elderly age, high CRP and 4C-scores correlated with the severity and mortality of COVID-19 patients. Convalescent plasma also significantly reduced inflammatory markers, especially in moderate COVID-19 patients. In non-critical hospitalized patients, convalescent plasma therapy reduces morbidity and mortality in moderate COVID-19 patients and hospitalization length. Identifying patients who could benefit from this treatment could reduce the risk of death and shorten their hospitalization stay.

Highlights

  • SARS-CoV-2 infection can develop into COVID-19, which manifests across a wide spectrum of clinical severity, ranging from a mild upper respiratory tract illness to diffuse viral pneumonia causing acute respiratory failure, with sequelae including acute lung injury, multiorgan dysfunction syndrome and death [1,2,3]

  • In-patient management revolves around the supportive management of the most common complications of severe COVID-19, like pneumonia, hypoxemic respiratory failure, acute respiratory distress syndrome (ARDS), sepsis and septic shock, acute kidney injury, along with complications from prolonged hospitalization [7]

  • The results show that convalescent plasma therapy significantly prevents mortality in moderate patients, reduced hospitalization length and time to negative polymerase chain reaction (PCR)

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Summary

Introduction

SARS-CoV-2 infection can develop into COVID-19, which manifests across a wide spectrum of clinical severity, ranging from a mild upper respiratory tract illness to diffuse viral pneumonia causing acute respiratory failure, with sequelae including acute lung injury, multiorgan dysfunction syndrome and death [1,2,3]. The virus itself causes lymphocyte apoptosis, impairing their function, and ending in a fulminant cytokine storm [4]. This condition resembles secondary hemophagocytic lymphohistiocytosis or macrophage activation syndrome and can progress to acute respiratory distress syndrome (ARDS) and multiorgan failure [5]. In-patient management revolves around the supportive management of the most common complications of severe COVID-19, like pneumonia, hypoxemic respiratory failure, ARDS, sepsis and septic shock, acute kidney injury, along with complications from prolonged hospitalization [7]. This study assesses the correlation between disease severity, presented as blood inflammatory marker levels and the reduction of these markers after plasma transfusion

Results
Discussion
Conclusions
Study Population
Study Design
Severity of Illness Categories Asymptomatic or pre-symptomatic infection
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