RESUMO
Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65x109/L vs. 0.76x109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials. Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.
RESUMO
Objective:To perform a statistical analysis of the ABO blood group distribution of COVID-19 convalescents, and further analyze the ABO blood group distribution in COVID-19 convalescents with different plasma antibody titer against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Methods:Convalescent plasma was collected from 150 patients aged 18-60 years old who had recovered from COVID-19. Convalescent plasma was collected 14 days later after patients discharged from hospital, and another 180 normal people in Wuhan city were served as healthy control group. Then we analyzed the relationship between age, gender and the ABO blood group distribution. We also tried to clarify the relationship between plasma antibody liter against SARS-CoV-2 and the ABO blood group distribution.Results:Compared with the healthy control group, the proportion of blood group B in COVID-19 convalescents was higher (36% vs 25.0%, χ 2=4.714, P<0.05). The ABO blood group distribution did not differ from male and female COVID-19 convalescents, while age affected the ABO blood group distribution of COVID-19 convalescents. Among the age group under 40 years old, the proportion of blood group B in COVID-19 convalescents was higher than that in the healthy control group (38.5% vs 25.0%, χ 2=5.264, P<0.05). The antibody titer against SARS-CoV-2 in 5.3% of the convalescent plasma was under 1:80. In the high antibody liter against SARS-CoV-2 group, the proportion of blood group B in COVID-19 convalescents was higher than that in the healthy control group (35.2% vs 25.0%, χ 2=3.979, P<0.05). Conclusions:COVID-19 convalescents with blood group B and age group under 40 years old have a higher proportions than that in the normal people. Part of the convalescents with lowantibody liter against SARS-CoV-2 didn’t meet the conditions for plasma donation. Convalescents with blood group B may be more suitable as plasma donators for the therapy of COVID-19.
