Asunto(s)
Enfermedades Pulmonares Intersticiales , Esclerodermia Sistémica , Humanos , Enfermedades Pulmonares Intersticiales/tratamiento farmacológico , Enfermedades Pulmonares Intersticiales/etiología , Inmunosupresores , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/tratamiento farmacológico , PulmónRESUMEN
OBJECTIVE: To study the effectiveness of COVID-19 convalescent plasma (CCP) therapy for patients with moderate and severe COVID-19 disease. METHODS: This non-randomized prospective cohort study was conducted from May 21 to June 30, 2020, at four major tertiary hospitals in Kuwait. CCP was administered to 135 patients. The control group comprised 233 patients who received standard treatment. All patients (N = 368, median age 54 [range 15-82]) had laboratory-confirmed SARS-CoV-2 infection and either moderate or severe COVID-19 disease. RESULTS: CCP treatment was associated with a higher rate of clinical improvement in patients with moderate or severe disease. Among those with moderate COVID-19 disease, time to clinical improvement was 7 days in the CCP group, versus 8 days in the control group (p = 0·006). For severe COVID-19 disease, time to clinical improvement was 7 days in the CCP group, versus 15.5 days in the control group (p = 0·003). In the adjusted analysis, patients with moderate disease treated with CCP had a significantly lower 30-day mortality rate. Compared to the control group, oxygen saturation improved within 3 days of CCP transfusion, and lymphocyte counts improved from day 7 in patients with moderate COVID-19 disease and day 11 in patients with severe disease. C-reactive protein levels declined throughout the first 14 days after CCP transfusion. None of the CCP patients developed a serious transfusion reaction. CONCLUSIONS: The data show that administration of CCP is a safe treatment option for patients with COVID-19 disease with a favorable outcome in the rate of, and time to, clinical improvement.
Asunto(s)
COVID-19/terapia , SARS-CoV-2 , Adulto , Femenino , Humanos , Inmunización Pasiva/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sueroterapia para COVID-19RESUMEN
We present a 37-year-old lady who had liver transplantation for hepatitis B cirrhosis and was on immune suppressive treatment consisting of mycophenolate mofetil (MMF) and tacrolimus. She presented with undue fatigue and recurring pain in both arms. The diagnosis of Takayasu's arteritis was made, supported by angiographic findings of significant stenosis of the left subclavian and both renal arteries. She was managed by adjusting the immune suppressive medications and underwent a successful percutaneous transluminal balloon angioplasty (PTBA).