Abstract
At present, neither specific curative treatment nor vaccines for novel coronavirus 2019 (COVID-19) are available. There is an urgent need to look for alternative strategies for COVID-19 treatment especially in the case of severe and/or critically ill patients with cytokine release syndrome (CRS). Convalescent plasma proved to increase survival rates in other severe viral infections. Therefore, convalescent plasma could be a promising treatment option for severe COVID-19 patients. In our article, we present the first two critically ill Hungarian patients with COVID-19 infection treated with convalescent fresh frozen plasma. At the time of plasma therapy both patients were on mechanical ventilation and received antiviral agents and a full scale of supportive care. Each patient received 3 × 200 mL of convalescent plasma of recently recovered donors with sufficient novel anti-coronavirus IgG titers. Subsequent to convalescent plasma infusion, oxygenization improved and inflammatory markers decreased in both individuals. As compared to pretransfusion, lymphocyte counts increased and interleukin-6 level lessened. Both patients were weaned from mechanical ventilation within 2 weeks of treatment. No severe adverse effects were observed. Our experience indicates that convalescent plasma therapy is well tolerated and could potentially improve clinical outcomes. Optimal dose and timing as well as precise assessment of clinical benefit of convalescent plasma therapy will need further investigation in larger, well-controlled trials. This is the first report of the successful use of convalescent plasma in the treatment of critically ill patients with COVID-19 infection in Hungary. Orv Hetil. 2020; 161(27): 1111-1121.
Highlights
At present, neither specific curative treatment nor vaccines for novel coronavirus 2019 (COVID-19) are available
There is an urgent need to look for alternative strategies for COVID-19 treatment especially in the case of severe and/or critically ill patients with cytokine release syndrome (CRS)
In our article, we present the first two critically ill Hungarian patients with COVID-19 infection treated with convalescent fresh frozen plasma
Summary
Convalescens friss fagyasztott plazmával történő terápia hazai alkalmazása intenzív osztályon kezelt, kritikus állapotú, COVID–19-fertőzésben szenvedő betegekben. Bekő Gabriella dr.4 ■ Hancz Lilla dr.1 ■ Lakatos Botond dr.. Sebestyén Gabriella dr.1 ■ Sinkó János dr.2 ■ Szlávik János dr.. Módszer: Két kritikus állapotú, COVID–19-fertőzött beteg convalescens friss fagyasztott plazmával történő kezelését mutatjuk be. A COVID–19-fertőzésből nemrég felépült és a súlyos akut légúti distressz szindrómát okozó koronavírus-2 elleni immunglobulin-G-t termelő donorokból 3 × 200 ml convalescens plazma transzfúzióját alkalmaztuk. A convalescens plazma transzfúzióját követően mindkét betegnél javult az oxigénszaturáció, és a gyulladásos értékeket jelző paraméterek csökkenést mutattak. Következtetések: Megfigyelésünk alapján a convalescens plazmával történő terápia jól tolerálható volt, és javíthatja a betegek gyógyulási arányát. Közleményünk megírásának célja az első két, hazánkban convalescens plazmával sikeresen kezelt, kritikus állapotú COVID–19-fertőzött beteg kórtörténetének bemutatása. Successful administration of convalescent plasma in critically ill COVID-19 patients in Hungary: the first two cases
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