Convalescent (Immune) Plasma Followed by Intravenous Immunoglobulin Infusion in an Adolescent with Severe COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has drawn attention over old immunotherapeutic agents such as convalescent (immune) plasma (CIP). Here, an adolescent with severe COVID-19 case requiring CIP and intravenous immunoglobulin (IVIG) treatments is described. A 17-year-old male patient was brought to the emergency room with complaints of fever, fatigue, and severe cough. Two doses of CIP were infused to the patient because of the increase in persisting fever, dyspnea, and acute phase reactant levels after the third day of routine protocol treatment. IVIG therapy was begun for 2 days at a dose of 1 g/kg/day due to resurgence in acute phase reactants and progressing radiological findings following CIP transfusion. Our patient avoided mechanical ventilation and showed immediate clinical and radiological improvement with CIP transfusion followed by IVIG therapy. Timely initiation of CIP treatment followed by IVIG prevented the disease from worsening and helped to reduce the requirement for mechanical ventilation.

Keywords

• COVID-19
• Convalescent (immune) plasma
• intravenous immunoglobulin

Şiddetli COVID-19’lu Ergende Konvalesan (İmmün) Plazmayı İzleyen İntravenöz İmmünoglobülin İnfüzyonu

Abstract

Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) pandemisi konvalesan (immün) plazma (CIP) gibi eski immünoterapötik ajanların üzerine dikkati çekmiştir. Burada, CIP ve intravenöz immünoglobulin (IVIG) tedavisi gerektiren şiddetli COVID-19 hastalığı olan bir adolesan olgu sunulmaktadır. 17 yaşında erkek hasta ateş, yorgunluk ve şiddetli öksürük yakınmalarıyla acil servise getirildi. Hastaya rutin protokol tedavisinin üçüncü gününden sonra devam eden ateş, nefes darlığı ve akut faz reaktan düzeylerindeki artış nedeniyle iki doz CIP infüzyonu uygulandı. CIP transfüzyonu sonrası akut faz reaktanlarında yeniden artış ve ilerleyen radyolojik bulgular nedeniyle 2 gün süreyle 1 g/kg/gün dozunda IVIG tedavisine başlandı. Hastamız CIP transfüzyonunu takiben IVIG tedavisiyle hemen klinik ve radyolojik iyileşme gösterdi ve mekanik vantilatör uygulamasından kurtuldu. CIP tedavisinin zamanında başlatılması ve ardından verilen IVIG, hastalığın kötüleşmesini önlemiş ve mekanik ventilasyon ihtiyacının azaltılmasına yardımcı olmuştur.

Keywords

• COVID-19
• intravenöz immunoglobulin
• Konvalesan (immün) plazma

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