Convalescent plasma therapy and mortality in COVID-19 patients admitted to the ICU: a prospective observational study

Annals of Intensive Care

Florian Prüller¹  Zdenka Sloup¹  Peter Schlenke²  Nazanin Sareban²  Konrad Rosskopf²  Michael Schörghuber³  Wolfgang Toller³  Katharina Gütl⁴  Stefan Pilz⁵  Hildegard T. Greinix⁶  Alexander R. Rosenkranz⁷  Florian Posch⁸  Martin Stradner⁹  Alexander C. Reisinger^1,10  Stefan Hatzl^1,10  Gernot Schilcher^1,10  Philipp Eller^1,10  Robert Krause^1,11 

[1] Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Graz;Department for Blood Group Serology and Transfusion Medicine, Medical University Graz;Department of Anesthesiology and Intensive Care Medicine, Medical University Graz;Division of Angiology, Department of Internal Medicine, Medical University of Graz;Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz;Division of Hematology, Department of Internal Medicine, Medical University of Graz;Division of Nephrology, Department of Internal Medicine, Medical University of Graz;Division of Oncology, Department of Internal Medicine, Medical University of Graz;Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz;Intensive Care Unit, Department of Internal Medicine, Medical University of Graz;Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz;

关键词: COVID-19;    ICU;    Intensive care;    Convalescent plasma;    Respiratory failure;    Acute respiratory distress syndrome;   

DOI  :  10.1186/s13613-021-00867-9

来源: DOAJ

【 摘 要 】

Abstract Background This study aimed to quantify the potential survival benefit of convalescent plasma therapy (CVP) in critically ill patients with acute respiratory failure related to coronavirus disease-2019 (COVID-19). Methods This is a single-center prospective observational cohort study in COVID-19 patients with acute respiratory failure. Immediately after intensive care unit (ICU) admission patients were allocated to CVP treatment following pre-specified criteria to rapidly identify those patients potentially susceptible for this treatment. A propensity score adjustment [inverse probability of treatment weighted (IPTW) analysis] was implemented to account rigorously for imbalances in prognostic variables between the treatment groups. Results We included 120 patients of whom 48 received CVP. Thirty percent were female with a median age of 66 years [25th–75th percentile 54–75]. Eighty-eight percent of patients presented with severe acute respiratory failure as displayed by a median paO2/FiO2 ratio (Horowitz Index) of 92 [77–150]. All patients required any kind of ventilatory support with more than half of them (52%) receiving invasive ventilation. Thirty-day ICU overall survival (OS) was 69% in the CVP group and 54% in the non-CVP group (log-rank p = 0.049), respectively. After weighing the time-to-event data for the IPTW, the favorable association between CVP and OS became even stronger (log-rank p = 0.035). Moreover, an exploratory analysis showed an overall survival benefit of CVP therapy for patients with non-invasive ventilation (Hazard ratio 0.12 95% CI 0.03–0.57, p = 0.007) Conclusion Administration of CVP in patients with acute respiratory failure related to COVID-19 is associated with improved ICU survival rates.

【 授权许可】

Unknown