{"title":"恢复期血浆治疗对重症COVID-19患者的免疫调节作用。","authors":"Munawaroh Fitriah, Aditea Etnawati Putri, Bambang Pujo Semedi, Atika Atika, Betty Agustina Tambunan","doi":"10.2147/OAEM.S405555","DOIUrl":null,"url":null,"abstract":"Introduction Convalescent plasma therapy (CPT) is an alternative therapy for managing COVID-19, but its use is still controversial. Objective Analyzing the effectiveness of CPT in modulating immune responses based on SARS-COV-2 anti-spike protein receptor-binding domain (s-RBD) IgG, inflammatory cytokines (IL-6 and IL-4), and mortality in severe-critical COVID-19 patients. Methods This study was an observational analytical with a prospective cohort design. The number of participants was 39 patients from June to December 2020. The participants received CPT and was tested for blood analysis such as IL-4, IL-6 and s-RBD IgG. The data were taken a day before CPT, 1st day, 2nd day, and 7th day after CPT. The analysis included Friedman, Pearson correlation, and Mann–Whitney test which is significant if p <0.05. Results The value of participant’s s-RBD IgG before CPT was 91.49 (0.43–3074.73) AU/mL and the 7th day post-CPT, s-RBD IgG value of 1169.79 (6.48–5577.91) AU/mL (p <0.001). The IL-4 value before CPT was 1.78 (0.85–5.21) ng/mL and the 7th day post-CPT, IL-4 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). The condition was also found in IL-6 value, in which the IL-4 value participant before CPT was 109.61 (0.73–4701.63) ng/mL and the 7th day post-CPT, IL-6 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). No significant correlation found between increased s-RBD IgG level with increased IL-4 and decreased IL-6 before and after CPT in severe-critical COVID-19 patients (p >0.05). No significant correlation was also found between increased s-RBD IgG levels, IL-4 too, and decreased IL-6 after CPT therapy between deceased and alive patients, both in 1st, 2nd, and 7th days (p >0.05). Conclusion No correlation between the increase in s-RBD IgG levels and changes in IL-4 and IL-6 levels. Changes in s-RBD IgG, IL-4, and IL-6 levels are not associated with mortality in severe-critical COVID-19 degree post CPT recipients.","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/37/oaem-15-109.PMC10143688.pdf","citationCount":"1","resultStr":"{\"title\":\"Immunomodulation Effect of Convalescent Plasma Therapy in Severe - Critical COVID-19 Patients.\",\"authors\":\"Munawaroh Fitriah, Aditea Etnawati Putri, Bambang Pujo Semedi, Atika Atika, Betty Agustina Tambunan\",\"doi\":\"10.2147/OAEM.S405555\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction Convalescent plasma therapy (CPT) is an alternative therapy for managing COVID-19, but its use is still controversial. Objective Analyzing the effectiveness of CPT in modulating immune responses based on SARS-COV-2 anti-spike protein receptor-binding domain (s-RBD) IgG, inflammatory cytokines (IL-6 and IL-4), and mortality in severe-critical COVID-19 patients. Methods This study was an observational analytical with a prospective cohort design. The number of participants was 39 patients from June to December 2020. The participants received CPT and was tested for blood analysis such as IL-4, IL-6 and s-RBD IgG. The data were taken a day before CPT, 1st day, 2nd day, and 7th day after CPT. The analysis included Friedman, Pearson correlation, and Mann–Whitney test which is significant if p <0.05. Results The value of participant’s s-RBD IgG before CPT was 91.49 (0.43–3074.73) AU/mL and the 7th day post-CPT, s-RBD IgG value of 1169.79 (6.48–5577.91) AU/mL (p <0.001). The IL-4 value before CPT was 1.78 (0.85–5.21) ng/mL and the 7th day post-CPT, IL-4 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). The condition was also found in IL-6 value, in which the IL-4 value participant before CPT was 109.61 (0.73–4701.63) ng/mL and the 7th day post-CPT, IL-6 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). No significant correlation found between increased s-RBD IgG level with increased IL-4 and decreased IL-6 before and after CPT in severe-critical COVID-19 patients (p >0.05). No significant correlation was also found between increased s-RBD IgG levels, IL-4 too, and decreased IL-6 after CPT therapy between deceased and alive patients, both in 1st, 2nd, and 7th days (p >0.05). Conclusion No correlation between the increase in s-RBD IgG levels and changes in IL-4 and IL-6 levels. Changes in s-RBD IgG, IL-4, and IL-6 levels are not associated with mortality in severe-critical COVID-19 degree post CPT recipients.\",\"PeriodicalId\":45096,\"journal\":{\"name\":\"Open Access Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/37/oaem-15-109.PMC10143688.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Access Emergency Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/OAEM.S405555\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Access Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OAEM.S405555","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Immunomodulation Effect of Convalescent Plasma Therapy in Severe - Critical COVID-19 Patients.
Introduction Convalescent plasma therapy (CPT) is an alternative therapy for managing COVID-19, but its use is still controversial. Objective Analyzing the effectiveness of CPT in modulating immune responses based on SARS-COV-2 anti-spike protein receptor-binding domain (s-RBD) IgG, inflammatory cytokines (IL-6 and IL-4), and mortality in severe-critical COVID-19 patients. Methods This study was an observational analytical with a prospective cohort design. The number of participants was 39 patients from June to December 2020. The participants received CPT and was tested for blood analysis such as IL-4, IL-6 and s-RBD IgG. The data were taken a day before CPT, 1st day, 2nd day, and 7th day after CPT. The analysis included Friedman, Pearson correlation, and Mann–Whitney test which is significant if p <0.05. Results The value of participant’s s-RBD IgG before CPT was 91.49 (0.43–3074.73) AU/mL and the 7th day post-CPT, s-RBD IgG value of 1169.79 (6.48–5577.91) AU/mL (p <0.001). The IL-4 value before CPT was 1.78 (0.85–5.21) ng/mL and the 7th day post-CPT, IL-4 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). The condition was also found in IL-6 value, in which the IL-4 value participant before CPT was 109.61 (0.73–4701.63) ng/mL and the 7th day post-CPT, IL-6 value of 1.97 (0.87–120.30) ng/mL (p = 0.401). No significant correlation found between increased s-RBD IgG level with increased IL-4 and decreased IL-6 before and after CPT in severe-critical COVID-19 patients (p >0.05). No significant correlation was also found between increased s-RBD IgG levels, IL-4 too, and decreased IL-6 after CPT therapy between deceased and alive patients, both in 1st, 2nd, and 7th days (p >0.05). Conclusion No correlation between the increase in s-RBD IgG levels and changes in IL-4 and IL-6 levels. Changes in s-RBD IgG, IL-4, and IL-6 levels are not associated with mortality in severe-critical COVID-19 degree post CPT recipients.