Effects of Plasma Therapy on Laboratory Factors and Clinical Improvement of COVID-19 Patients
-
Behrooz Ghezelbash
,
Marjan Golabi
,
Negah Tavakol
,
Azam Mesgari
,
Reihaneh Shamsfar
,
Ramin Sami
,
Nahid Eskandari
Abstract
Objective: Over 50 million confirmed cases and 1.5 million fatalities worldwide have been linked to the COVID-19 pandemic. Researchers have used convalescent plasma (CP) from recovered patients, including neutralizing antibodies, to develop therapeutics for virus neutralization and prevention. This study assessed the effectiveness of CP by using several clinical and laboratory variables.
Methods: The intervention group received two doses of CP on the day of hospitalization, while the control group received standard care. Clinical and analytical data were documented and evaluated before plasma therapy and on the third and fifth days after therapy. The results included measurements were measured in the patient's blood using the ELISA method.
Results: The present study showed that the ICU hospitalization times for the control and CP groups were similar, with a slightly lower mortality rate in the CP group (6.2% vs. 8.2%, p > 0.05). There was no significant association between COVID-19 and clinical factors such as blood pressure, heart rate (HR), respiration rate (RR), and temperature. The blood serum urea, serum LDH, ALT, PTT, PLT, and IL-6 were significantly higher in the CP group than in the control group (p <0.05). Our results indicated that there was no difference in blood pH, PO2, HCO3, ESR, WBC counts, serum troponin, Na, AST, CRP, D-dimer, and PT between patients in the CP and control groups.
Conclusion: Overall, in certain instances, CP therapy may help individuals with covid-19 recover. In general, additional research is required to determine the efficacy of plasma treatment in COVID-19 patient care.
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7. Duan, K., B. Liu, C. Li, H. Zhang, T. Yu, J. Qu, et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings of the National Academy of Sciences, 2020. 117(17): p. 9490-9496.
8. Dassarma, B., S. Tripathy, and M. Matsabisa, Emergence of ancient convalescent plasma (CP) therapy: To manage COVID-19 pandemic. Transfusion Clinique et Biologique, 2021. 28(1): p. 123-127.
9. Piyush, R., K. Rajarshi, R. Khan, and S. Ray, Convalescent plasma therapy: a promising coronavirus disease 2019 treatment strategy. Open Biology, 2020. 10(9): p. 200174.
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11. Cunningham, A., H. Goh, and D. Koh, Treatment of COVID-19: Old tricks for new challenges. Vol. 24. Critical Care. BioMed Central Ltd, 2020: p. 91.
12. Chan, K., K. Lee, P. Lam, K. Law, G.M. Joynt, and W. Yan, Hong Kong’s experience on the use of extracorporeal membrane oxygenation for the treatment of influenza A (H1N1). Hong Kong Med J, 2010. 16(6): p. 447-454.
13. Zhang, H., Y. Zeng, Z. Lin, W. Chen, J. Liang, H. Zhang, et al., Clinical characteristics and therapeutic experience of case of severe highly pathogenic A/H5N1 avian influenza with bronchopleural fistula. Zhonghua jie he he hu xi za zhi= Zhonghua Jiehe he Huxi Zazhi= Chinese Journal of Tuberculosis and Respiratory Diseases, 2009. 32(5): p. 356-359.
14. Nguyen, F.T., T. van den Akker, K. Lally, H. Lam, V. Lenskaya, S.T. Liu, et al., Transfusion reactions associated with COVID‐19 convalescent plasma therapy for SARS‐CoV‐2. Transfusion, 2021. 61(1): p. 78-93.
15. Cheng, Y., R. Wong, Y. Soo, W. Wong, C. Lee, M. Ng, et al., Use of convalescent plasma therapy in SARS patients in Hong Kong. European Journal of Clinical Microbiology and Infectious Diseases, 2005. 24: p. 44-46.
16. Casadevall, A., J.P. Henderson, M.J. Joyner, and L.-A. Pirofski, SARS-CoV-2 variants and convalescent plasma: reality, fallacies, and opportunities. The Journal of clinical investigation, 2021. 131(7).
17. Luchsinger, L.L., B.P. Ransegnola, D.K. Jin, F. Muecksch, Y. Weisblum, W. Bao, et al., Serological assays estimate highly variable SARS-CoV-2 neutralizing antibody activity in recovered COVID-19 patients. Journal of clinical microbiology, 2020. 58(12): p. e02005-20.
18. Wang, Y., P. Huo, R. Dai, X. Lv, S. Yuan, Y. Zhang, et al., Convalescent plasma may be a possible treatment for COVID-19: A systematic review. Int Immunopharmacol, 2021. 91: p. 107262.
19. Covid, F.I., convalescent plasma-emergency INDs. US Food And Drug Administration, 2020.
20. Jorda, A., M. Kussmann, N. Kolenchery, J.M. Siller-Matula, M. Zeitlinger, B. Jilma, et al., Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis. Front Immunol, 2022. 13: p. 817829.
21. Li, L., W. Zhang, Y. Hu, X. Tong, S. Zheng, J. Yang, et al., Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. Jama, 2020. 324(5): p. 460-470.
22. Abolghasemi, H., P. Eshghi, A.M. Cheraghali, A.A.I. Fooladi, F.B. Moghaddam, S. Imanizadeh, et al., Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study. Transfusion and Apheresis Science, 2020. 59(5): p. 102875.
23. Gharbharan, A., C.C. Jordans, C. Geurtsvankessel, J.G. den Hollander, F. Karim, F.P. Mollema, et al., Convalescent plasma for COVID-19. A randomized clinical trial. MEDRxiv, 2020: p. 2020.07. 01.20139857.
24. Salazar, E., K.K. Perez, M. Ashraf, J. Chen, B. Castillo, P.A. Christensen, et al., Treatment of COVID-19 patients with convalescent plasma in Houston, Texas. medRxiv, 2020: p. 2020.05. 08.20095471.
25. Hegerova, L., T.A. Gooley, K.A. Sweerus, C. Maree, N. Bailey, M. Bailey, et al., Use of convalescent plasma in hospitalized patients with COVID-19: case series. Blood, 2020. 136(6): p. 759-762.
26. Xia, X., K. Li, L. Wu, Z. Wang, M. Zhu, B. Huang, et al., Improved clinical symptoms and mortality on severe/critical COVID-19 patients utilizing convalescent plasma transfusion. Blood, 2020. 136(6): p. 755-759.
27. Shen, C., Z. Wang, F. Zhao, Y. Yang, J. Li, J. Yuan, et al., Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. Jama, 2020. 323(16): p. 1582-1589.
28. Soo, Y., Y. Cheng, R. Wong, D. Hui, C. Lee, K. Tsang, et al., Retrospective comparison of convalescent plasma with continuing high‐dose methylprednisolone treatment in SARS patients. Clinical microbiology and infection, 2004. 10(7): p. 676-678.
29. Duan, K., B. Liu, C. Li, H. Zhang, T. Yu, J. Qu, et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A, 2020. 117(17): p. 9490-9496.
30. Zhang, B., S. Liu, T. Tan, W. Huang, Y. Dong, L. Chen, et al., Treatment With Convalescent Plasma for Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Chest, 2020. 158(1): p. e9-e13.
31. Ortigoza, M.B., H. Yoon, K.S. Goldfeld, A.B. Troxel, J.P. Daily, Y. Wu, et al., Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients: A Randomized Clinical Trial. JAMA Intern Med, 2022. 182(2): p. 115-126.
32. Libster, R., G. Pérez Marc, D. Wappner, S. Coviello, A. Bianchi, V. Braem, et al., Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. N Engl J Med, 2021. 384(7): p. 610-618.
33. Li, L., W. Zhang, Y. Hu, X. Tong, S. Zheng, J. Yang, et al., Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. Jama, 2020. 324(5): p. 460-470.
34. Pouladzadeh, M., M. Safdarian, P. Eshghi, H. Abolghasemi, A.G. Bavani, B. Sheibani, et al., A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm. Internal and emergency medicine, 2021: p. 1-11.
35. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet, 2021. 397(10289): p. 2049-2059.
36. Zeng, Q.L., Z.J. Yu, J.J. Gou, G.M. Li, S.H. Ma, G.F. Zhang, et al., Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019. J Infect Dis, 2020. 222(1): p. 38-43.
37. Acosta-Ampudia, Y., D.M. Monsalve, M. Rojas, Y. Rodríguez, J.E. Gallo, J.C. Salazar-Uribe, et al., COVID-19 convalescent plasma composition and immunological effects in severe patients. J Autoimmun, 2021. 118: p. 102598.
38. MacLennan, S. and J.A. Barbara, Risks and side effects of therapy with plasma and plasma fractions. Best Pract Res Clin Haematol, 2006. 19(1): p. 169-89.
39. Dhawan, M., M. Parmar, S. Angural, and O.P. Choudhary, Convalescent plasma therapy against the emerging SARS-CoV-2 variants: delineation of the potentialities and risks. International Journal of Surgery, 2022. 97: p. 106204.
40. Moubarak, M., K.I. Kasozi, H.F. Hetta, H.M. Shaheen, A. Rauf, H.M. Al-Kuraishy, et al., The rise of SARS-CoV-2 variants and the role of convalescent plasma therapy for management of infections. Life, 2021. 11(8): p. 734.
41. Wang, K.Y., P. Shah, and M. Pierce, Convalescent plasma for COVID-19 complicated by ARDS due to TRALI. BMJ case reports CP, 2021. 14(1): p. e239762.
42. Nagoba, B., A. Gavkare, N. Jamadar, S. Mumbre, and S. Selkar, Positive aspects, negative aspects and limitations of plasma therapy with special reference to COVID-19. Journal of infection and public health, 2020. 13(12): p. 1818-1822.
43. Chai, K.L., S.J. Valk, V. Piechotta, C. Kimber, I. Monsef, C. Doree, et al., Convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19: a living systematic review. Cochrane Database of Systematic Reviews, 2020(10).
2. Kafieh, R., R. Arian, N. Saeedizadeh, Z. Amini, N.D. Serej, S. Minaee, et al., COVID-19 in Iran: forecasting pandemic using deep learning. Computational and mathematical methods in medicine, 2021. 2021.
3. Owusu, M., A.A. Sylverken, S.T. Ankrah, P. El-Duah, N.K. Ayisi-Boateng, R. Yeboah, et al., Epidemiological profile of SARS-CoV-2 among selected regions in Ghana: A cross-sectional retrospective study. PLoS One, 2020. 15(12): p. e0243711.
4. Çalıca Utku, A., G. Budak, O. Karabay, E. Güçlü, H.D. Okan, and A. Vatan, Main symptoms in patients presenting in the COVID-19 period. Scottish medical journal, 2020. 65(4): p. 127-132.
5. Wolff, D., S. Nee, N.S. Hickey, and M. Marschollek, Risk factors for Covid-19 severity and fatality: a structured literature review. Infection, 2021. 49: p. 15-28.
6. Focosi, D., A.O. Anderson, J.W. Tang, and M. Tuccori, Convalescent plasma therapy for COVID-19: state of the art. Clinical microbiology reviews, 2020. 33(4): p. e00072-20.
7. Duan, K., B. Liu, C. Li, H. Zhang, T. Yu, J. Qu, et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings of the National Academy of Sciences, 2020. 117(17): p. 9490-9496.
8. Dassarma, B., S. Tripathy, and M. Matsabisa, Emergence of ancient convalescent plasma (CP) therapy: To manage COVID-19 pandemic. Transfusion Clinique et Biologique, 2021. 28(1): p. 123-127.
9. Piyush, R., K. Rajarshi, R. Khan, and S. Ray, Convalescent plasma therapy: a promising coronavirus disease 2019 treatment strategy. Open Biology, 2020. 10(9): p. 200174.
10. Zhang, L. and Y. Liu, Potential interventions for novel coronavirus in China: A systematic review. Journal of medical virology, 2020. 92(5): p. 479-490.
11. Cunningham, A., H. Goh, and D. Koh, Treatment of COVID-19: Old tricks for new challenges. Vol. 24. Critical Care. BioMed Central Ltd, 2020: p. 91.
12. Chan, K., K. Lee, P. Lam, K. Law, G.M. Joynt, and W. Yan, Hong Kong’s experience on the use of extracorporeal membrane oxygenation for the treatment of influenza A (H1N1). Hong Kong Med J, 2010. 16(6): p. 447-454.
13. Zhang, H., Y. Zeng, Z. Lin, W. Chen, J. Liang, H. Zhang, et al., Clinical characteristics and therapeutic experience of case of severe highly pathogenic A/H5N1 avian influenza with bronchopleural fistula. Zhonghua jie he he hu xi za zhi= Zhonghua Jiehe he Huxi Zazhi= Chinese Journal of Tuberculosis and Respiratory Diseases, 2009. 32(5): p. 356-359.
14. Nguyen, F.T., T. van den Akker, K. Lally, H. Lam, V. Lenskaya, S.T. Liu, et al., Transfusion reactions associated with COVID‐19 convalescent plasma therapy for SARS‐CoV‐2. Transfusion, 2021. 61(1): p. 78-93.
15. Cheng, Y., R. Wong, Y. Soo, W. Wong, C. Lee, M. Ng, et al., Use of convalescent plasma therapy in SARS patients in Hong Kong. European Journal of Clinical Microbiology and Infectious Diseases, 2005. 24: p. 44-46.
16. Casadevall, A., J.P. Henderson, M.J. Joyner, and L.-A. Pirofski, SARS-CoV-2 variants and convalescent plasma: reality, fallacies, and opportunities. The Journal of clinical investigation, 2021. 131(7).
17. Luchsinger, L.L., B.P. Ransegnola, D.K. Jin, F. Muecksch, Y. Weisblum, W. Bao, et al., Serological assays estimate highly variable SARS-CoV-2 neutralizing antibody activity in recovered COVID-19 patients. Journal of clinical microbiology, 2020. 58(12): p. e02005-20.
18. Wang, Y., P. Huo, R. Dai, X. Lv, S. Yuan, Y. Zhang, et al., Convalescent plasma may be a possible treatment for COVID-19: A systematic review. Int Immunopharmacol, 2021. 91: p. 107262.
19. Covid, F.I., convalescent plasma-emergency INDs. US Food And Drug Administration, 2020.
20. Jorda, A., M. Kussmann, N. Kolenchery, J.M. Siller-Matula, M. Zeitlinger, B. Jilma, et al., Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis. Front Immunol, 2022. 13: p. 817829.
21. Li, L., W. Zhang, Y. Hu, X. Tong, S. Zheng, J. Yang, et al., Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. Jama, 2020. 324(5): p. 460-470.
22. Abolghasemi, H., P. Eshghi, A.M. Cheraghali, A.A.I. Fooladi, F.B. Moghaddam, S. Imanizadeh, et al., Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study. Transfusion and Apheresis Science, 2020. 59(5): p. 102875.
23. Gharbharan, A., C.C. Jordans, C. Geurtsvankessel, J.G. den Hollander, F. Karim, F.P. Mollema, et al., Convalescent plasma for COVID-19. A randomized clinical trial. MEDRxiv, 2020: p. 2020.07. 01.20139857.
24. Salazar, E., K.K. Perez, M. Ashraf, J. Chen, B. Castillo, P.A. Christensen, et al., Treatment of COVID-19 patients with convalescent plasma in Houston, Texas. medRxiv, 2020: p. 2020.05. 08.20095471.
25. Hegerova, L., T.A. Gooley, K.A. Sweerus, C. Maree, N. Bailey, M. Bailey, et al., Use of convalescent plasma in hospitalized patients with COVID-19: case series. Blood, 2020. 136(6): p. 759-762.
26. Xia, X., K. Li, L. Wu, Z. Wang, M. Zhu, B. Huang, et al., Improved clinical symptoms and mortality on severe/critical COVID-19 patients utilizing convalescent plasma transfusion. Blood, 2020. 136(6): p. 755-759.
27. Shen, C., Z. Wang, F. Zhao, Y. Yang, J. Li, J. Yuan, et al., Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. Jama, 2020. 323(16): p. 1582-1589.
28. Soo, Y., Y. Cheng, R. Wong, D. Hui, C. Lee, K. Tsang, et al., Retrospective comparison of convalescent plasma with continuing high‐dose methylprednisolone treatment in SARS patients. Clinical microbiology and infection, 2004. 10(7): p. 676-678.
29. Duan, K., B. Liu, C. Li, H. Zhang, T. Yu, J. Qu, et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A, 2020. 117(17): p. 9490-9496.
30. Zhang, B., S. Liu, T. Tan, W. Huang, Y. Dong, L. Chen, et al., Treatment With Convalescent Plasma for Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Chest, 2020. 158(1): p. e9-e13.
31. Ortigoza, M.B., H. Yoon, K.S. Goldfeld, A.B. Troxel, J.P. Daily, Y. Wu, et al., Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients: A Randomized Clinical Trial. JAMA Intern Med, 2022. 182(2): p. 115-126.
32. Libster, R., G. Pérez Marc, D. Wappner, S. Coviello, A. Bianchi, V. Braem, et al., Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. N Engl J Med, 2021. 384(7): p. 610-618.
33. Li, L., W. Zhang, Y. Hu, X. Tong, S. Zheng, J. Yang, et al., Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. Jama, 2020. 324(5): p. 460-470.
34. Pouladzadeh, M., M. Safdarian, P. Eshghi, H. Abolghasemi, A.G. Bavani, B. Sheibani, et al., A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm. Internal and emergency medicine, 2021: p. 1-11.
35. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet, 2021. 397(10289): p. 2049-2059.
36. Zeng, Q.L., Z.J. Yu, J.J. Gou, G.M. Li, S.H. Ma, G.F. Zhang, et al., Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019. J Infect Dis, 2020. 222(1): p. 38-43.
37. Acosta-Ampudia, Y., D.M. Monsalve, M. Rojas, Y. Rodríguez, J.E. Gallo, J.C. Salazar-Uribe, et al., COVID-19 convalescent plasma composition and immunological effects in severe patients. J Autoimmun, 2021. 118: p. 102598.
38. MacLennan, S. and J.A. Barbara, Risks and side effects of therapy with plasma and plasma fractions. Best Pract Res Clin Haematol, 2006. 19(1): p. 169-89.
39. Dhawan, M., M. Parmar, S. Angural, and O.P. Choudhary, Convalescent plasma therapy against the emerging SARS-CoV-2 variants: delineation of the potentialities and risks. International Journal of Surgery, 2022. 97: p. 106204.
40. Moubarak, M., K.I. Kasozi, H.F. Hetta, H.M. Shaheen, A. Rauf, H.M. Al-Kuraishy, et al., The rise of SARS-CoV-2 variants and the role of convalescent plasma therapy for management of infections. Life, 2021. 11(8): p. 734.
41. Wang, K.Y., P. Shah, and M. Pierce, Convalescent plasma for COVID-19 complicated by ARDS due to TRALI. BMJ case reports CP, 2021. 14(1): p. e239762.
42. Nagoba, B., A. Gavkare, N. Jamadar, S. Mumbre, and S. Selkar, Positive aspects, negative aspects and limitations of plasma therapy with special reference to COVID-19. Journal of infection and public health, 2020. 13(12): p. 1818-1822.
43. Chai, K.L., S.J. Valk, V. Piechotta, C. Kimber, I. Monsef, C. Doree, et al., Convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19: a living systematic review. Cochrane Database of Systematic Reviews, 2020(10).
| Files | ||
| Issue | Vol 2 No 1 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/abi.v2i1.16246 | |
| Keywords | ||
| COVID-19 Plasma Therapy Clinical Improvement Laboratory Parameters | ||
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How to Cite
1.
Ghezelbash B, Golabi M, Tavakol N, Mesgari A, Shamsfar R, Sami R, Eskandari N. Effects of Plasma Therapy on Laboratory Factors and Clinical Improvement of COVID-19 Patients. ABI. 2024;2(1):36-44.
