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A severe refractory COVID-19 patient responding to convalescent plasma; A case series.

ABSTRACT: Introduction:Although some medicines are under research, currently, no specific antiviral drug has been approved to target 2019 novel coronavirus. In this report two severe cases of 2019 novel coronavirus disease (COVID-19) patients have been described who received convalescent plasma (CP). Case report:Two male cases (a 46-year-old and a 56-year-old) after being diagnosed with severe COVID-19, they deteriorated despite supportive care and antiviral therapy. They started to improve with CP infusion both clinically and radiologically. Finally they were discharged in a very well condition with negative virology tests. Conclusion:CP might be an effective therapy for severe COVID-19 patients.

SUBMITTER: Abdullah HM

PROVIDER: S-EPMC7327024 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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A severe refractory COVID-19 patient responding to convalescent plasma; A case series.

Abdullah Hadi Mohammed HM Hama-Ali Hersh H HH Ahmed Sabah Nasraddin SN Ali Kosar Muhammad KM Karadakhy Kamaran Amin KA Mahmood Safeen Othman SO Mahmood Zana Hameed ZH Hamad Amin Karmand Qadir KQ Atta Peshnyar Muhammad PM Nuradeen Bryar Ezadeen BE Mohammed Shvan H SH Salih Rawezh Q RQ Baba Hiwa O HO Kakamad Fahmi H FH

Annals of medicine and surgery (2012) 20200624

<h4>Introduction</h4>Although some medicines are under research, currently, no specific antiviral drug has been approved to target 2019 novel coronavirus. In this report two severe cases of 2019 novel coronavirus disease (COVID-19) patients have been described who received convalescent plasma (CP).<h4>Case report</h4>Two male cases (a 46-year-old and a 56-year-old) after being diagnosed with severe COVID-19, they deteriorated despite supportive care and antiviral therapy. They started to improve ...[more]

PMID: 32637086

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Project description:Convalescent plasma (CP) has emerged as a treatment for COVID-19. However, the composition and mechanism of action are not fully known. Therefore, we undertook a two-phase controlled study in which, first the immunological and metabolomic status of recovered and severe patients were evaluated. Secondly, the 28-day effect of CP on the immune response in severe patients was assessed. Nineteen recovered COVID-19 patients, 18 hospitalized patients with severe disease, and 16 pre-pandemic controls were included. Patients with severe disease were treated with CP transfusion and standard therapy (i.e., plasma recipients, n = 9) or standard therapy alone (n = 9). Clinical and biological assessments were done on day 0 and during follow-up on days 4, 7, 14, and 28. Clinical parameters, viral load, total immunoglobulin (Ig) G and IgA anti-S1-SARS-CoV-2 antibodies, neutralizing antibodies (NAbs), autoantibodies, cytokines, T and B cells, and metabolomic and lipidomic profiles were examined. Total IgG and IgA anti-S1-SARS-CoV-2 antibodies were key factors for CP selection and correlated with NAbs. In severe COVID-19 patients, mostly interleukin (IL)-6 (P = <0.0001), IL-10 (P = <0.0001), IP-10 (P = <0.0001), fatty acyls and glycerophospholipids were higher than in recovered patients. Latent autoimmunity and anti-IFN-α antibodies were observed in both recovered and severe patients. COVID-19 CP induced an early but transient cytokine profile modification and increases IgG anti-S1-SARS-CoV-2 antibodies. At day 28 post-transfusion, a decrease in activated, effector and effector memory CD4+ (P < 0.05) and activated and effector CD8+ (P < 0.01) T cells and naïve B cells (P = 0.001), and an increase in non-classical memory B cells (P=<0.0001) and central memory CD4+ T cells (P = 0.0252) were observed. Moreover, IL-6/IFN-γ (P = 0.0089) and IL-6/IL-10 (P = 0.0180) ratios decreased in plasma recipients compared to those who received standard therapy alone. These results may have therapeutic implications and justify further post-COVID-19 studies.

Dataset Information

A severe refractory COVID-19 patient responding to convalescent plasma; A case series.

Publications

A severe refractory COVID-19 patient responding to convalescent plasma; A case series.

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