Effect of Immune Plasma Therapy on Mortality and Morbidity in Patients with Covid-19: A Retrospective Study

Hayriye Bektaş Aksoy, I. Aksoy, Selda Günaydın, Abdülbaki Elmas, A. Dülger
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Abstract

Objective: Immune plasma therapy, a method employed for passive immunization, has been utilized as a treatment modality based on historical precedents during the Covid-19 pandemic, a global crisis resulting in the unfortunate demise of countless individuals. The objective of this study is to investigate the impact of immune plasma therapy on laboratory parameters and the overall survival rate in patients with Covid-19 pneumonia. Material and Methods: Our study was designed as a retrospective analysis, conducted at a tertiary healthcare institution from April 1, 2020, to December 31, 2020. The study population comprised individuals aged 18 and above, presenting with pulmonary involvement, and diagnosed with Covid-19 using the polymerase chain reaction (PCR) method at our hospital. The inclusion criteria encompassed patients who received immune plasma therapy, as well as a control group matched for age, gender, and admission date, who did not undergo immune plasma therapy. Exclusion criteria involved patients with low serum IgA levels, those who did not provide consent for immune plasma therapy, and individuals below the age of 18. Results: The study comprised a total of 72 patients who received immune plasma therapy and 72 patients in the control group, matched for age and gender, all diagnosed with Covid-19. The median age of the patients was 70 years, ranging from 19 to 91, and 56.9% (41) of them were female. When comparing the immune plasma group with the control group, several significant differences were observed (p<0.05). These included elevated levels of leukocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), glucose, aspartate aminotransferase (AST), sedimentation rate, C-reactive protein (CRP), ferritin, fibrinogen, d-dimer, and low levels of platelets and lymphocytes in the control group. Furthermore, in the immune plasma therapy group, significant associations were found between mortality and lymphocyte count, NLR, AST, CRP, and d-dimer elevation after treatment (p<0.05). Additionally, pre- and post-treatment measurements of troponin, procalcitonin, and ferritin were significantly correlated with mortality (p<0.05). Conclusion: The administration of immune plasma therapy, involving the transfer of neutralizing antibodies, has demonstrated a favorable impact on laboratory parameters and overall survival in severe cases of Covid-19 pneumonia, particularly during the early stages of the disease.
免疫血浆治疗对Covid-19患者死亡率和发病率影响的回顾性研究
目的:基于历史先例,在导致无数人不幸死亡的全球危机Covid-19大流行期间,免疫血浆疗法作为被动免疫的一种治疗方式被使用。本研究旨在探讨免疫血浆治疗对Covid-19肺炎患者实验室参数和总生存率的影响。材料和方法:本研究设计为回顾性分析,于2020年4月1日至2020年12月31日在一家三级医疗机构进行。研究人群包括18岁及以上,肺部受累,并在我院使用聚合酶链反应(PCR)方法诊断为Covid-19的个体。纳入标准包括接受免疫血浆治疗的患者,以及年龄、性别和入院日期相匹配的对照组,未接受免疫血浆治疗。排除标准包括血清IgA水平低的患者、不同意接受免疫血浆治疗的患者以及18岁以下的个体。结果:该研究共包括72名接受免疫血浆治疗的患者和72名年龄和性别匹配的对照组患者,均被诊断为Covid-19。患者年龄中位数为70岁,19 ~ 91岁,女性占56.9%(41例)。免疫血浆组与对照组比较,差异有统计学意义(p<0.05)。其中包括对照组白细胞、中性粒细胞、中性粒细胞与淋巴细胞比值(NLR)、葡萄糖、天冬氨酸转氨酶(AST)、沉降率、c反应蛋白(CRP)、铁蛋白、纤维蛋白原、d-二聚体水平升高,血小板和淋巴细胞水平降低。此外,在免疫血浆治疗组,死亡率与治疗后淋巴细胞计数、NLR、AST、CRP和d-二聚体升高有显著相关性(p<0.05)。此外,治疗前后肌钙蛋白、降钙素原和铁蛋白的测量与死亡率显著相关(p<0.05)。结论:在Covid-19肺炎重症病例中,特别是在疾病早期,免疫血浆治疗(涉及中和抗体的转移)已被证明对实验室参数和总体生存有有利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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