Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study
Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study
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DOI：
10.1038/s41591-020-1088-9
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发表时间：
2020-09-15
期刊：
影响因子：
82.9
通讯作者：
Bouvier, Nicole M.
中科院分区：
文献类型：
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作者：
Liu, Sean T. H.;Lin, Hung-Mo;Bouvier, Nicole M.
在与匹配对照的回顾性比较中，用于治疗COVID-19住院患者的恢复期血浆与生存率提高相关，支持在随机对照试验中进一步研究。冠状病毒病2019 （COVID-19）是由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起的一种新型人类疾病，目前有效治疗方法很少(1)。由COVID-19康复者捐献的恢复期血浆是血液中的非细胞成分，含有抗体，包括特异性识别SARS-CoV-2的抗体。当将这些抗体输注到感染SARS-CoV-2的患者体内时，被认为能发挥抗病毒作用，在患者产生自身体液免疫反应之前抑制病毒复制（2,3）。来自康复患者的病毒特异性抗体往往是新出现的传染病的第一种可用疗法，是在开发新的抗病毒药物和疫苗时的一种权宜之计（1,2）。这项回顾性、倾向评分匹配的病例对照研究评估了纽约市西奈山医院39例重症或危及生命的COVID-19患者恢复期血浆治疗的有效性。17.9%的血浆接受者输血后第14天的需氧量恶化，而因COVID-19住院的倾向评分匹配的对照组为28.2%(校正优势比（OR）， 0.86；95%置信区间（CI）， 0.75-0.98；卡方testPvalue = 0.025)。血浆受体的生存率也有所提高(校正风险比（HR）， 0.34；95% ci, 0.13-0.89；卡方检验p = 0.027)。恢复期血浆可能对COVID-19有效，但需要进行足够有力的随机对照试验。
Convalescent plasma for treatment of hospitalized patients with COVID-19 is associated with improved survival in a retrospective comparison with matched controls, supporting further study in randomized controlled trials.Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments(1). Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. These antibodies, when transfused into patients infected with SARS-CoV-2, are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses(2,3). Virus-specific antibodies from recovered persons are often the first available therapy for an emerging infectious disease, a stopgap treatment while new antivirals and vaccines are being developed(1,2). This retrospective, propensity score-matched case-control study assessed the effectiveness of convalescent plasma therapy in 39 patients with severe or life-threatening COVID-19 at The Mount Sinai Hospital in New York City. Oxygen requirements on day 14 after transfusion worsened in 17.9% of plasma recipients versus 28.2% of propensity score-matched controls who were hospitalized with COVID-19 (adjusted odds ratio (OR), 0.86; 95% confidence interval (CI), 0.75-0.98; chi-square testPvalue = 0.025). Survival also improved in plasma recipients (adjusted hazard ratio (HR), 0.34; 95% CI, 0.13-0.89; chi-square testP = 0.027). Convalescent plasma is potentially effective against COVID-19, but adequately powered, randomized controlled trials are needed.