Convalescent Plasma Treatment Research Articles

Convalescent Plasma Treatment for Moderate to Critical Ill COVID-19 Patients – A Safe but Futile Treatment: A Non-Randomized Comparative Study

Background: In a number of cases of viral infection, convalescent plasma therapy has been effective. Reportedly, the use of convalescent plasma as a therapy for COVID-19 patients with severe and life-threatening disorders is beneficial at this time. This study aims to assess the effectiveness and safety of convalescent plasma transfusions in hospitalized COVID-19 patients. Subjects and Method: This was a clinical trial employing a non-randomized comparative study. A historical control group (21 samples) and convalescent plasma transfusions (21 samples) was selected consecutively from hospitalized COVID-19 patients between May 6th, 2020, and May 6th, 2021 at Dr. Moewardi General Hospital. We assessed and quantified viral clearance in the laboratory. Statistical analysis is performed in SPSS version 20.0. Results: Plasma was taken from fifteen convalescent donors. In the plasma convalescent treatment group, there was a statistically significant difference between outcome and severity degree (p = 0.005). In addition, there was a substantial discrepancy between the result group and the control group (p 0.005). Significant differences in post-treatment NLR between the control and treatment groups (p 0.005). In addition, there were statistically significant differences between the control and treatment groups in post-treatment hsCRP levels (p 0.005). In addition, there were statistically significant differences (p 0.005) between all groups' inflammatory markers and outcomes. Conclusion: Using convalescent plasma to treat patients with COVID-19 is a rather safe practice. Our analysis demonstrated that the administration of convalescent plasma did not enhance survival or clinical outcomes for COVID-19 patients with moderate to severe disease. Keywords: COVID-19, convalescent therapy, critical ill

Percentile-Based Adaptive Immune Plasma Algorithm and Its Application to Engineering Optimization.

The immune plasma algorithm (IP algorithm or IPA) is one of the most recent meta-heuristic techniques and models the fundamental steps of immune or convalescent plasma treatment, attracting researchers' attention once more with the COVID-19 pandemic. The IP algorithm determines the number of donors and the number of receivers when two specific control parameters are initialized and protects their values until the end of termination. However, determining which values are appropriate for the control parameters by adjusting the number of donors and receivers and guessing how they interact with each other are difficult tasks. In this study, we attempted to determine the number of plasma donors and receivers with an improved mechanism that depended on dividing the whole population into two sub-populations using a statistical measure known as the percentile and then a novel variant of the IPA called the percentile IPA (pIPA) was introduced. To investigate the performance of the pIPA, 22 numerical benchmark problems were solved by assigning different values to the control parameters of the algorithm. Moreover, two complex engineering problems, one of which required the filtering of noise from the recorded signal and the other the path planning of an unmanned aerial vehicle, were solved by the pIPA. Experimental studies showed that the percentile-based donor-receiver selection mechanism significantly contributed to the solving capabilities of the pIPA and helped it outperform well-known and state-of-art meta-heuristic algorithms.

P‐TS‐97 | Vaccine‐Boosted Convalescent Plasma Treatment in Immunosuppressed Patients with Mild or Moderate COVID‐19

P‐TS‐97 | Vaccine‐Boosted Convalescent Plasma Treatment in Immunosuppressed Patients with Mild or Moderate COVID‐19

Convalescent plasma and all-cause mortality of COVID-19 patients: systematic review and meta-analysis

Insight into the clinical potential of convalescent plasma in patients with coronavirus disease (COVID-19) is important given the severe clinical courses in unvaccinated and seronegative individuals. The aim of the study was to investigate whether there is a survival benefit of convalescent plasma therapy in COVID-19 patients. The authors independently assessed randomized controlled trials (RCTs) identified by the search strategy for inclusion, extracted data, and assessed risk of bias. The binary primary outcome was all-cause mortality. Risk ratio (RR) of the convalescent plasma treatment (vs. best standard care) and its associated standard error (effect size) were calculated. A random-effects model was employed to statistically pool the effect sizes of the selected studies. We included 19 RCTs with 17,021 patients. The random-effects model resulted in an estimated pooled RR of 0.94 (95% CI 0.81–1.08, p = 0.33), showing no statistical evidence of the benefit of convalescent plasma therapy on all-cause mortality. Convalescent plasma therapy was not found to be effective in reducing all-cause mortality in COVID-19 patients. Further studies are needed to determine in which patients convalescent plasma therapy may lead to a reduction in mortality.

A Three-Dimensional UCAV Path Planning Approach Based on Immune Plasma Algorithm

Path planning of an unmanned aerial vehicle (UAV) or its variant supported with weapon systems, also called unmanned combat aerial vehicle (UCAV), is one of the most crucial steps for the autonomous flight and requires compelling decisions being made by considering the existence of the enemy defence, obstacles, and battery or fuel capacity of the vehicle optimally before starting the flight. Immune plasma algorithm (IP algorithm or IPA), inspired by the convalescent plasma treatment which is a medical method being popularized again with the rise of new coronavirus or COVID-19, has been introduced recently as a new optimization technique and the promising performance of the mentioned algorithm validated through a set of numerical and engineering problems. In this study, the IP algorithm was specialized as a three-dimensional UCAV path planner for the first time. Its performance was investigated particularly by using three different battlefield environments and assigning various constants to the population size. Moreover, the effect of two IPA-specific control parameters that are responsible for determining the number of donors and number of receivers on the qualities of the calculated paths were analyzed in detail. The results obtained by the IPA were compared with the results of other three-dimensional path planners guiding optimization algorithms such as simulated annealing (SA), gray wolf optimizer (GWO) and symbiotic organism search (SOS). Experimental studies showed that the main idea lying behind the usage of qualified solutions as donors and transferring information directly from them to the receivers representing the poor solutions of the problem gives a positive contribution to the exploitation-dominant operations of IPA and fully complies with the challenging requirements of the path planning problem. Especially in the battlefields for which an optimal or near optimal path contains complex maneuvers, the advantages from the subtly balanced operational steps of the IPA become more apparent by setting the number of donors and receivers appropriately and IPA is found to be more stable and successful compared to the other tested algorithms.

Assessment of Laboratory and Clinical Data in COVID-19 Patients Treated by Convalescent Plasma

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has affected over 200 million individuals worldwide, and finding a treatment to control and eradicate the disease is considered a critical issue. Different drugs and therapies have been used since the beginning of the pandemic; however, effective infection control has not been achieved. Convalescent plasma (CP) that contains immune factors (neutralizing antibodies and inflammatory) can be an effective way to treat some infections, as it was previously used to control the pandemic. Objectives: The present study aimed to assess the effect of CP infusion on some clinical indicators of coronavirus disease 2019 (COVID-19). Methods: This study investigated the effects of CP treatment on some clinical factors, such as C-reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and D-dimer among 125 patients in two groups, including a CP-treated group and a non-treated control group, in Ali-Asghar Hospital of Shiraz, Iran. Results: Mortality rate analysis between CP-treated and control groups showed a 31% reduction (53% and 84% mortality in CP-treated and non-treated control groups, respectively). In addition, the clinical factor analysis of CP-treated patients showed a significant change in D-dimer on the seventh day (P = 0.036) and oxygen saturation (SpO2) (P = 0.00), lymphocyte count (P = 0.00), platelet (P = 0.005), and ESR (P = 0.007) between the first and fourth days of treatment. Moreover, CP-treated patients were separated into two age groups. It was observed that on the fourth day, the rate of SpO2 and lymphocyte count were significantly different in patients under 50 years compared to patients ≥ 50 years (P = 0.004 and P = 0.011, respectively); a similar finding was shown for lymphocyte count on the seventh day after CP infusion (P = 0.012). The results also revealed a significant difference between males and females in lymphocyte count after CP treatment on the fourth and seventh days (P = 0.006 and P = 0.042, respectively). Conclusions: The results demonstrated the potential impact of CP infusion on the laboratory data of COVID-19-infected patients. Accordingly, this method could have a practical effect on reducing and even suppressing inflammation, infection, and mortality rate among these patients. However, further studies are needed to obtain more accurate results.

Early, very high-titre convalescent plasma therapy in clinically vulnerable individuals with mild COVID-19 (COVIC-19): protocol for a randomised, open-label trial

IntroductionCOVID-19 convalescent plasma (CCP) is a possible treatment option for COVID-19. A comprehensive number of clinical trials on CCP efficacy have already been conducted. However, many aspects of CCP treatment...

The Relationship Between SARS-CoV-2 Neutralizing Antibody Titers and Avidity in Plasma Collected From Convalescent Nonvaccinated and Vaccinated Blood Donors.

Convalescent plasma (CP) treatment of coronavirus disease 2019 (COVID-19) has shown significant therapeutic effect when administered early (eg, Argentinian trial showing reduced hospitalization) but has in general been ineffective (eg, REMAP-CAP trial without improvement during hospitalization). To investigate whether the differences in CP used could explain the different outcomes, we compared neutralizing antibodies, anti-spike IgG, and avidity of CP used in the REMAP-CAP and Argentinian trials and in convalescent vaccinees. We found no difference between the trial plasmas, emphasizing initial patient serostatus as treatment efficacy predictor. By contrast, vaccinee CP showed significantly higher titers and avidity, being preferable for future CP treatment. Clinical Trials Registration. NCT02735707 and NCT04479163.

Convalescent Plasma Therapy for COVID-19: A Systematic Review and Meta-Analysis on Randomized Controlled Trials

Background: While passive immunotherapy has been considered beneficial for patients with severe respiratory viral infections, the treatment of COVID-19 cases with convalescent plasma produced mixed results. Thus, there is a lack of certainty and consensus regarding its effectiveness. This meta-analysis aims to assess the role of convalescent plasma treatment on the clinical outcomes of COVID-19 patients enrolled in randomized controlled trials (RCTs). Methods: A systematic search was conducted in the PubMed database (end-of-search: 29 December 2022) for RCTs on convalescent plasma therapy compared to supportive care\standard of care. Pooled relative risk (RR) and 95% confidence intervals were calculated with random-effects models. Subgroup and meta-regression analyses were also performed, in order to address heterogeneity and examine any potential association between the factors that varied, and the outcomes reported. The present meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 34 studies were included in the meta-analysis. Per overall analysis, convalescent plasma treatment was not associated with lower 28-day mortality [RR = 0.98, 95% CI (0.91, 1.06)] or improved 28-day secondary outcomes, such as hospital discharge [RR = 1.00, 95% CI (0.97, 1.03)], ICU-related or score-related outcomes, with effect estimates of RR = 1.00, 95% CI (0.98, 1.05) and RR = 1.06, 95% CI (0.95, 1.17), respectively. However, COVID-19 outpatients treated with convalescent plasma had a 26% less risk of requiring hospital care, when compared to those treated with the standard of care [RR = 0.74, 95% CI (0.56, 0.99)]. Regarding subgroup analyses, COVID-19 patients treated with convalescent plasma had an 8% lower risk of ICU-related disease progression when compared to those treated with the standard of care (with or without placebo or standard plasma infusions) [RR = 0.92, 95% CI (0.85, 0.99)] based on reported outcomes from RCTs carried out in Europe. Finally, convalescent plasma treatment was not associated with improved survival or clinical outcomes in the 14-day subgroup analyses. Conclusions: Outpatients with COVID-19 treated with convalescent plasma had a statistically significantly lower risk of requiring hospital care when compared to those treated with placebo or the standard of care. However, convalescent plasma treatment was not statistically associated with prolonged survival or improved clinical outcomes when compared to placebo or the standard of care, per overall analysis in hospitalized populations. This hints at potential benefits, when used early, to prevent progression to severe disease. Finally, convalescent plasma was significantly associated with better ICU-related outcomes in trials carried out in Europe. Well-designed prospective studies could clarify its potential benefit for specific subpopulations in the post-pandemic era.

Convalescent Plasma Treatment of Patients Previously Treated with B-Cell-Depleting Monoclonal Antibodies Suffering COVID-19 Is Associated with Reduced Re-Admission Rates

Patients receiving treatment with B-cell-depleting monoclonal antibodies, such as anti-CD20 monoclonal antibodies, such as rituximab and obinutuzumab, either for hematological disease or another diagnosis, such as a rheumatological disease, are at an increased risk for medical complications and mortality from COVID-19. Since inconsistencies persist regarding the use of convalescent plasma (CP), especially in the vulnerable patient population that has received previous treatment with B-cell-depleting monoclonal antibodies, further studies should be performed in thisdirection. The aim of the present study was to describe the characteristics of patients with previous use of B-cell-depleting monoclonal antibodies and describe the potential beneficial effects of CP use in terms of mortality, ICU admission and disease relapse. In this retrospective cohort study, 39 patients with previous use of B-cell-depleting monoclonal antibodies hospitalized in the COVID-19 department of a tertiary hospital in Greece were recorded and evaluated. The mean age was 66.3 years and 51.3% were male. Regarding treatment for COVID-19, remdesivir was used in 89.7%, corticosteroids in 94.9% and CP in 53.8%. In-hospital mortality was 15.4%. Patients who died were more likely to need ICU admission and also had a trend towards a longer hospital stay, even though the last did not reach statistical significance. Patients treated with CP had a lower re-admission rate for COVID-19 after discharge. Further studies should be performed to identify the role of CP in patients with treatment with B-cell-depleting monoclonal antibodies suffering from COVID-19.

Reduced Mortality among COVID-19 ICU Patients after Treatment with HemoClear Convalescent Plasma in Suriname.

Convalescent plasma is a promising therapy for coronavirus disease 2019 (COVID-19), but its efficacy in intensive care unit (ICU) patients in low- and middle-income country settings such as Suriname is unknown. Bedside plasma separation using the HemoClear device made convalescent plasma therapy accessible as a treatment option in Suriname. Two hundred patients with severe SARS-CoV-2 infection requiring intensive care were recruited. Fifty eight patients (29%) received COVID-19 convalescent plasma (CCP) treatment in addition to standard of care (SOC). The CCP treatment and SOC groups were matched by age, sex, and disease severity scores. Mortality in the CCP treatment group was significantly lower than that in the SOC group (21% versus 39%; Fisher's exact test P = 0.0133). Multivariate analysis using ICU days showed that CCP treatment reduced mortality (hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.18 to 0.66; P = 0.001), while complication of acute renal failure (creatinine levels, >110 mol/L; HR, 4.45; 95% CI, 2.54 to 7.80; P < 0.0001) was independently associated with death. Decrease in chest X-ray score in the CCP treatment group (median -3 points, interquartile range [IQR] -4 to -1) was significantly greater than that in the SOC group (median -1 point, IQR -3 to 1, Mann-Whitney test P = 0.0004). Improvement in the PaO2/FiO2 ratio was also significantly greater in the CCP treatment group (median 83, IQR 8 to 140) than in the SOC group (median 35, IQR -3 to 92, Mann-Whitney P = 0.0234). Further research is needed for HemoClear-produced CCP as a therapy for SARS-CoV-2 infection together with adequately powered, randomized controlled trials. IMPORTANCE This study compares mortality and other endpoints between intensive care unit COVID-19 patients treated with convalescent plasma plus standard of care (CCP), and a control group of patients hospitalized in the same medical ICU facility treated with standard of care alone (SOC) in a low- and middle-income country (LMIC) setting using bedside donor whole blood separation by gravity (HemoClear) to produce the CCP. It demonstrates a significant 65% survival improvement in HemoClear-produced CCP recipients (HR, 0.35; 95% CI, 0.19 to 0.66; P = 0.001). Although this is an exploratory study, it clearly shows the benefit of using the HemoClear-produced CCP in ICU patients in the Suriname LMIC setting. Additional studies could further substantiate our findings and their applicability for both LMICs and high-income countries and the use of CCP as a prepared readiness method to combat new viral pandemics.

Immune Plasma for the Treatment of COVID-19: Lessons Learned so far.

COVID-19 convalescent plasma (CCP) has been explored as one of the treatment options for COVID-19. Results of many cohort studies and clinical trials have been recently published. At first glance, the results of the CCP studies appear to be inconsistent. However, it became clear that CCP is not beneficial if CCP with low anti-SARS-CoV-2 antibody concentrations is used, if it is administered late in advanced disease stages, and to patients who already mounted an antibody response against SARS-CoV-2 at the time of CCP transfusion. On the other hand, CCP may prevent progression to severe COVID-19 when very high-titer CCP is given early in vulnerable patients. Immune escape of new variants is a challenge for passive immunotherapy. While new variants of concern developed resistance to most clinically used monoclonal antibodies very rapidly, immune plasma from individuals immunized by both a natural SARS-CoV-2 infection and SARS-CoV-2 vaccination retained neutralizing activity against variants. This review briefly summarizes the evidence on CCP treatment to date and identifies further research needs. Ongoing research on passive immunotherapy is not only relevant for improving care for vulnerable patients in the ongoing SARS-CoV-2 pandemic, but even more as a model for passive immunotherapy in case of future pandemics with a newly evolving pathogen. Compared to other drugs, which must be newly developed in a pandemic (e.g., monoclonal antibodies, antiviral drugs), convalescent plasma is rapidly available, inexpensive to produce, and can be adaptive to viral evolution by selection of contemporary convalescent donors.

Early Treatment with Monoclonal Antibodies or Convalescent Plasma Reduces Mortality in Non-Vaccinated COVID-19 High-Risk Patients

Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants.

A multi-population immune plasma algorithm for path planning of unmanned combat aerial vehicle

Autonomous flight of an unmanned aerial vehicle (UAV) or its weaponized variant named unmanned combat aerial vehicle (UCAV) requires a route or path determined carefully by considering the optimization objectives about the enemy threats and fuel consumption of the system being operated. Immune Plasma algorithm (IP algorithm or IPA) is one of the most recent optimization techniques and directly models the fundamental steps of a medical method also used for the COVID-19 disease and known as convalescent or immune plasma treatment. In this study, IP algorithm for which a promising performance has already been validated with a single population was first extended to a multi-population domain supported by a migration schema. Moreover, the usage of the donor as a source of plasma for the treatment operations of a receiver was remodeled. The new variant of the IPA empowered with the multi-population and modified donor usage approach was called Multi-IP algorithm or MULIPA. For investigating the solving capabilities of the MULIPA as a UCAV path planner, different battlefield scenarios and algorithm specific parameter configurations were used. The results obtained by the MULIPA were compared with the results of other meta-heuristic based path planners. The comparative studies between MULIPA and other techniques showed that newly proposed IPA variant is capable of finding more secure and fuel efficient paths for a UCAV system.

The Covid-19 Antibody Titer of Convalescence Plasma Repeated Donors at Red Cross Indonesia of Tulungagung Regency

Convalescent plasma is plasma that is already present in the body and includes anti-SARS-CoV-2 antibodies. This plasma includes antibodies that may kill viral particles, thereby preventing virus entrance into cells. This neutralizing procedure has an effect on the improvement of a patient's clinical state after receiving convalescent plasma treatment. The possibility of this convalescent plasma therapy as a treatment for individuals infected with SARS-CoV-2 has been evaluated, and clinical trials are still ongoing. The aim of this study is to determine the antibody titer of the donor. The research was a descriptive study. Total sample was 25 repeated male donors. The data of their IgM and IgG levels was obtained from Management Information System at Red Cross Indonesia Of Tulungagung Regency. Data was presented as table. The mean IgG level of repeated convalescent plasma donors is higher than the mean IgM level. The mean IgM level of repeated convalescent plasma donors is often constant. The mean IgG level of convalescent plasma donors increased through the fifth donor and then declined from the sixth to the ninth donor. The mean result of IgM and IgG has decreased by a higher proportion than it has increased.

A systematic review of the safety and efficacy of convalescent plasma or immunoglobulin treatment for people with severe respiratory viral infections due to coronaviruses or influenza.

Evaluate the safety and effectiveness of convalescent plasma (CP) or hyperimmune immunoglobulin (hIVIG) in severe respiratory disease caused by coronaviruses or influenza, in patients of all ages requiring hospital admission. We searched multiple electronic databases for all publications to 12th October 2020, and RCTs only to 28th June 2021. Two reviewers screened, extracted, and analysed data. We used Cochrane ROB (Risk of Bias)1 for RCTs, ROBINS-I for non-RCTs, and GRADE to assess the certainty of the evidence. Data from 30 RCTs and 2 non-RCTs showed no overall difference between groups for all-cause mortality and adverse events in four comparisons. Certainty of the evidence was downgraded for high ROB and imprecision. (1) CP versus standard care (SoC) (20 RCTS, 2 non-RCTs, very-low to moderate-high certainty); (2) CP versus biologically active control (6 RCTs, very-low certainty); (3) hIVIG versus SoC (3 RCTs, very-low certainty); (4) early CP versus deferred CP (1 RCT, very-low certainty). Subgrouping by titre improved precision in one outcome (30-day mortality) for the 'COVID high-titre' category in Comparison 1 (no difference, high certainty) and Comparison 2 (favours CP, very-low certainty). Post hoc analysis suggests a possible benefit of CP in patients testing negative for antibodies at baseline, compared with those testing positive. A minimum titre should be established and ensured for a positive biological response to the therapy. Further research on the impact of CP/hIVIG in patients who have not yet produced antibodies to the virus would be useful to target therapies at groups who will potentially benefit the most.

Convalescent plasma treatment for SARS-CoV-2 infected high-risk patients: a matched pair analysis to the LEOSS cohort

Establishing the optimal treatment for COVID-19 patients remains challenging. Specifically, immunocompromised and pre-diseased patients are at high risk for severe disease course and face limited therapeutic options. Convalescent plasma (CP) has been considered as therapeutic approach, but reliable data are lacking, especially for high-risk patients. We performed a retrospective analysis of 55 hospitalized COVID-19 patients from University Hospital Duesseldorf (UKD) at high risk for disease progression, in a substantial proportion due to immunosuppression from cancer, solid organ transplantation, autoimmune disease, dialysis. A matched-pairs analysis (1:4) was performed with 220 patients from the Lean European Open Survey on SARS-CoV-2-infected Patients (LEOSS) who were treated or not treated with CP. Both cohorts had high mortality (UKD 41.8%, LEOSS 34.1%). A matched-pairs analysis showed no significant effect on mortality. CP administration before the formation of pulmonary infiltrates showed the lowest mortality in both cohorts (10%), whereas mortality in the complicated phase was 27.8%. CP administration during the critical phase revealed the highest mortality: UKD 60.9%, LEOSS 48.3%. In our cohort of COVID-19 patients with severe comorbidities CP did not significantly reduce mortality in a retrospective matched-pairs analysis. However, our data supports the concept that a reduction in mortality is achievable by early CP administration.

Efficacy of therapeutic plasma exchange and convalescent plasma therapy in moderate-to-severe COVID-19 patients

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health catastrophe since its first reported cases in late December 2019. Critically ill COVID-19 patients have been related to cytokine storms leading to acute respiratory distress syndrome and high mortality rates. Therapeutic plasma exchange (TPE) and convalescent plasma (CP) therapy improve clinically by removing inflammatory cytokines excess and using passive antibody-containing blood, respectively. This study aimed to evaluate TPE and CP treatment for moderate-to-severe COVID-19 infection. Method: The patients were randomly divided into TPE group (n = 10), CP group (n = 11), and control group (n = 10). This 1-week quasi-experimental study with a pretest–post-test control group design was conducted in the Intensive Care Unit (ICU) of Dr. Moewardi General Hospital and Universitas Sebelas Maret (UNS) Hospital. The study comparison between groups included blood gas analysis profile (pH, base excess, PaCO2, PaO2, hematocrit, HCO3, total CO2, SaO2), FiO2, P/F ratio, COVID-19 severity, and D-dimer. The paired t-test was used to analyze every group's pretest–post-test mean difference. One-way ANOVA was performed to analyze the mean difference across the three groups. SPSS version 22.0 for Windows was used to perform statistical analyses. Result: TPE and CP groups showed significant clinical-laboratory improvement than control (p &gt; 0.05). Furthermore, high clinical-laboratory improvement tendency was observed in CP therapy than TPE. Conclusion: The use of TPE and CP in moderate-to-severe COVID-19 patients has been related to improving clinical-laboratory outcomes.

INVESTIGATING HETEROGENEITY OF TREATMENT EFFECT FOR CONVALESCENT PLASMA IN SEVERE COVID-19: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

INVESTIGATING HETEROGENEITY OF TREATMENT EFFECT FOR CONVALESCENT PLASMA IN SEVERE COVID-19: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Lenfopenik Olan Hafif COVID-19 Vakalarında İmmun Plazma Tedavisi Ne Kadar Güvenliydi?

Aim: Many treatment methods have endeavored during the Coronavirus Disease of 2019 (COVID-19) pandemic. Particularly before the vaccines came into use, the medical world gained adequate experience with convalescent plasma (CP) administration, which was ignored after preventive remedies. In this study, we compared the clinical conditions and treatments during the infection with pulmonary fibrosis after recovery.&#x0D; Material and Method: This prospective, cross-sectional study was conducted with COVID-19 patients. The patients were divided into two groups according to the severity of the disease. Sixty of them were reevaluated regarding pulmonary fibrosis via high-resolution computed tomography performed in the 6th month after recovery.&#x0D; Results: A total of 60 patients (mean age=54.05±9.16) participated in this study. Both severe and non-severe groups were equal in the number of patients. There was no difference between the groups in the evaluation of fibrosis scores. However, in those with pulmonary fibrosis, age, CURB-65 scores, and D-dimer levels were found to be higher, whereas hematocrit levels were lower. In lymphopenic patients, almost 95% of those who underwent CP treatment had fibrosis (p=0.013). This fibrosis formation was more prominent in the non-severe group (p=0.028). Comparable fibrosis increation persisted in diabetics.&#x0D; Conclusion: Based on the results, the pulmonary involvement of COVID-19 may form persistent fibrosis after recovery. The accuracy of administering CP treatment in non-severe patients with lymphopenia should be reviewed, as it might increase pulmonary fibrosis.