Early high-titer convalescent plasma therapy in patients with moderate and severe COVID-19.

BACKGROUND AND OBJECTIVES: The use of COVID-19 convalescent plasma (CCP) has been approved by the FDA. We assessed the outcome of patients with moderate and severe COVID-19 following convalescent plasma therapy and the association with variables such as antibody titer in CCP units and transfusion time. MATERIALS AND METHODS: In this prospective cohort study, 3097 patients with moderate and severe COVID-19 (according to WHO Progression Scale) had heterogeneous demographic and clinical characteristics received plasma with an unknown titer at the transfusion time. Firstly, information about age, sex, blood group, the time interval from hospitalization to CCP transfusion, underlying disease, and antibody titer with the outcome were investigated. Then, multivariate logistic regression and area under the curve (AUC) were performed for the association between disease severity and intubation variables with transfusion time and outcome. RESULTS: Patients with younger age receiving CCP in the first five days of hospitalization had lower mortality (P < 0.0001). Moreover, patients without the underlying disease had lower mortality (P < 0.001). The mortality rate also decreased in severe patients who were intubated receiving CCP for less than five days (P < 0.001). In patients with moderate severity (score less than 5) who received IgG antibody levels above 1:320 in less than five days had lower mortality (P < 0.0001). CONCLUSION: Our findings suggested that COVID-19 patients with the moderate type of disease receiving CCP units with high antibody titers in the early stages of the disease experienced greater effectiveness of CCP therapy.

Seroprevalence study of hepatitis C and Hepatitis B virus among hospitalized intravenous drug users in Ahvaz, Iran (2002-2006).

BACKGROUND AND AIMS: Viral hepatitis is a serious complication among intravenous drug users (IDUs). The objectives of this study were to determine the seroprevalence of hepatitis B and C viruses (HBV and HCV), and associated risk factors among IDUs at a teaching hospital in Ahvaz, southwest Iran. METHODS: Medical records of 333 IDUs hospitalized from 2002 to 2006 at Razi Hospital, which is affiliated to Ahvaz Jundishapur University of Medical Sciences, were reviewed. Cases meeting the criteria for a diagnosis of viral hepatitis infection were included in this study. Patients' characteristics, clinical and laboratory findings were extracted. Data of cases with hepatitis virus infection (HVI), called the HVI group and without HVI, called the NHVI group, were compared, using the chi-square test for qualitative variables and the t-test for quantitative variables. Differences with a P < 0.05 were considered significant. RESULTS: Out of a total of 333 IDUs, 115 (34.5%), mostly male, with a mean age of 24.8±6.2 had HVI. More than 65% had a history of imprisonment. The mean duration of IDU was 4.5±1.6 years for the HVI group and 1.8±0.4 years for the NHVI group (P < 0.05). 85% of the HVI group and 45% of the NHVI group shared injection equipment (P < 0.05). 103 patients (30.9%) had HCV and 12 (3.6%) had HBV infection. There was a significant difference in age, duration of drug abuse, time spent in prison, sharing injection equipment, history of surgery, blood transfusion, packs of cigarettes per year and human immunodeficiency virus (HIV) co-infection between the two groups (P < 0.05). CONCLUSIONS: HVI in IDU population is a prevalent complication, and is associated with heavy smoking (high number of packs of cigarettes per year), sharing injection equipment, long duration of drug usage, long duration of prison stay, HIV co-infection, history of surgery, blood and blood products transfusion. Older age, longer duration of IDU and imprisonment put the cases at higher risk of acquiring HCV in comparison to HBV.