J Infectious Dis: 早期恢复期血浆治疗对非重症 COVID-19 住院的死亡率影响

2021-09-21 MedSci原创 MedSci原创

2019年底爆发的冠状病毒病 (COVID-19)大流行目前已经成为美国主要的死亡原因,大多数感染者很少或没有症状。

      2019年底爆发的冠状病毒病 (COVID-19)大流行目前已经成为美国主要的死亡原因,虽然大多数感染者很少或没有症状,但是少数会出现严重的症状并导致住院并需要补充氧气支持,并很有可能导致多器官衰竭。而从 COVID-19 中康复的人含有大量抗病毒药物和抗炎成分,将恢复期患者的血浆注射入新冠患者体内疗法很早就成为 COVID-19 的治疗策略。虽然 COVID-19患者恢复期血浆疗法已被证明是安全的,但仍有随机试验证实其存在一定的安全隐患。因此,本项研究旨在探究早期恢复期血浆输注是否会降低非严重冠状病毒病 (COVID-19) 患者的死亡率。

 

      本研究使用来自于 2020 年 5 月 1 日至 11 月 17 日期间因患非严重 COVID-19而住院的患者的临床数据。血浆干预是在患者住院 2 天内进行的恢复期血浆疗法。然后使用累积发生率曲线、风险差异和从汇集逻辑模型估计的风险比比较接受与不接受血浆疗法的患者其 30 天死亡率。

 

      总共有11269名符合实验条件的患者,402 人被分配到恢复期血浆组。血浆组和非血浆组分别有 40 人和 671 人死亡。血浆组的估计 30 天死亡风险为 6.5%(95% 置信区间 [CI],4.0%–9.7%),非血浆组为 6.2%(95% CI,5.6%–7.0%)。相关风险差异为 0.30%(95% CI,-2.30% 至 3.60%),风险比为 1.04(95% CI,0.64-1.62)。

 

      从本项研究中,研究人员证实,接受和未接受恢复期血浆治疗的非重症 COVID-19 患者的 30 天死亡率没有显着差异,恢复期血浆治疗是安全有效的。

 

 

原始出处 :

Kelly Cho. Et al. Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere COVID-19: An Observational Analysis Emulating a Target Trial. The Journal of Infectious Diseases.2021.

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