Our convalescent plasma experiences in COVID-19 patients hospitalized in the intensive care unit

Abstract

Objective: Despite vaccine and drug studies, convalescent plasma (CP) therapy remains an alternative treatment for coronavirus disease 2019 (COVID-19). In this study, we aimed to reveal the efficacy of CP therapy on mortality and the factors affecting it for the patients diagnosed with COVID-19 and acute respiratory distress syndrome (ARDS) which were followed in our intensive care unit (ICU). Material and Method: The data (demographic characteristics, the amount of CP used, PaO2/FiO2, leukocyte, neutrophil, lymphocyte, D-Dimer, C-reactive protein (CRP), procalcitonin, ferritin values, and the clinical findings) of the patients who were hospitalized in the ICU with the diagnosis of COVID-19 and received CP treatment between 20 March and 20 October 2020 were analyzed retrospectively. Data of deceased patients (n=29) and survivors (n=50) were compared with each other and logistic regression analysis was performed to investigate the relationship with mortality. Results: 79 patients who received 166 units of CP therapy after a mean of 13.45±3.6 days symptom onset, were identified. 96.2% of the patients had at least one concomitant disease. Mortality was observed in 29 (36.7%) of the patients. Mortality (5.1%) was less common in those receiving CP therapy within the first 14 days after the onset of symptoms. Patient age (p=0.041), neutrophil/lymphocyte ratio (p=0.004), CRP values (p=0.002), the number of comorbidities (p<0.001), PaO2/FiO2 ratio before CP (p=0.005), and the period when CP was first infused from symptom onset (p<0.001) had a statistically significant effect on mortality. Conclusion: CP can be safely used to treat COVID-19. However, its positive effect is less observed in patients with the advanced stage of the disease, progressive deterioration of oxygenation, and a high number of comorbidities. For this reason, starting CP treatment at an early stage may increase its effectiveness.

Keywords

• Convalescent (immune) plasma
• COVID-19
• Intensive care unit
• SARS-Cov-2

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