COVID-19 patients treated with convalescent plasma. / Covid-19-pasienter behandlet med rekonvalesensplasma.

BACKGROUND: In Norway, treatment with COVID-19 convalescent plasma has been given through the NORPLASMA project. The treatment was initially offered to critically ill patients after an individual assessment, but from December 2020, the indication was limited to critically ill, immunocompromised patients. In this article we describe clinical characteristics, comorbidity and mortality in patients who received convalescent plasma in these two periods. MATERIAL AND METHOD: From 22 April 2020 to 30 March 2022, a total of 79 patients were included in the observational studies NORPLASMA MONITOR and the Norwegian SARS-CoV-2 study. The patients had received a total of 193 units of convalescent plasma at 15 Norwegian hospitals/nursing homes; 62 in South-Eastern Norway Regional Health Authority, 8 in Western Norway Regional Health Authority and 9 in Central Norway Regional Health Authority. Information on immune status, comorbidity and course of infection was retrieved from the patient records after informed written consent was obtained. RESULTS: Of 79 patients with a median age of 65 years (interquartile range 51-⁠73) who were treated with convalescent plasma, 31 (39 %) died during hospitalisation. A total of 59 patients were immunocompromised, and of these, 20 died in hospital compared to 11 of 20 who were assumed to be immunocompetent. Median number of comorbidities was 2 (interquartile range 1-4). The patients received a median of two plasma units (min.-max. 1-21). Two of the patients developed mild allergic skin reactions. INTERPRETATION: Convalescent plasma was well tolerated by patients with COVID-19. Immunocompromised patients may have benefitted from the treatment, with lower mortality than for those assumed to be immunocompetent.

Convalescent plasma from Norwegian blood donors to treat COVID-19. / Rekonvalesensplasma mot covid-19 fremstilt fra norske blodgivere.

BACKGROUND: At the start of the pandemic, the Norwegian Directorate of Health and Norwegian blood banks initiated the production of COVID-19 convalescent plasma within the framework of clinical studies. In this article we describe the blood donors who participated. MATERIAL AND METHOD: Blood donors who had recovered from COVID-19 were recruited to donate single donor plasma for the purpose of patient treatment. Data on the course of infection, leukocyte antibodies and antibody level against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) per plasma unit were registered after informed consent was obtained. We calculated a disease score defined as the total number of self-reported symptoms/findings and hospitalisation where relevant (score 0-⁠11). RESULTS: A total of 1644 plasma units were collected from 266 plasma donors at 12 blood banks. Median disease score was 5 (interquartile range 3-⁠6), and 15 donors had recovered from pneumonia and/or been hospitalised. A total of 599/1644 plasma units from 106/266 donors met our requirement for SARS-CoV-2 antibody content (> 60 % inhibition of virus binding to angiotensin-converting enzyme 2 (ACE2)) or positive virus neutralisation test. The antibody level in donors waned over time following infection, and showed no clear correlation with disease score. INTERPRETATION: The number of symptoms and findings in blood donors could not predict antibody response at individual level, and antibody testing was crucial for the production of effective convalescent plasma.

Transfusion practice at Sørlandet Hospital / Transfusjonspraksis i Sørlandet sykehus.

BACKGROUND: Norway has no overview of the number of patients who are transfused, their age and gender distribution or reasons for transfusion. We wished to investigate which patient groups received blood at Sørlandet Hospital in 2010-2011, and to test a method of electronic data linkage from treatment systems, with a view to further monitoring of blood consumption. MATERIAL AND METHOD: Data from all patients treated in somatic departments at Sørlandet Hospital in the period from 1 January 2010 to 31 December 2011 were linked to data from the blood bank with the aid of the system 'Forskning i sykehus'. SPSS version 23.0 was used for the statistical analyses. RESULTS: A total of 19 108 red blood cells and platelet concentrates were transfused to 3 967 patients, with the same number of units for both genders. Patients older than 60 years accounted for 79 % of the total blood consumption. Patients in the main diagnostic group neoplasms had the most transfusion episodes, followed by the diagnostic groups injuries, diseases of the digestive system and diseases of the blood. In cases of primary and secondary hip prostheses, 33.8 % and 65.6 % of the patients received blood, respectively. For caesarean section the figure was 8.9 %. INTERPRETATION: Our data are comparable to data from other countries. The method is suitable for assessing and monitoring transfusion practice. It could also be used by other health trusts and to collect national data after all blood components and parameters such as haemoglobin, blood group and transfusion complications are included.

Irradiation to prevent a fatal transfusion complication. / Bestråling for å hindre en fatal transfusjonskomplikasjon.

Cellular blood components should be irradiated as a preventive measure against transfusion-associated graft-versus-host disease in severely immunocompromised patients.