NEJM:恢复期血浆不能降低高危门诊新冠肺炎患者病情进展风险

2021-08-20 MedSci原创 MedSci原创

在Covid-19症状出现后1周内给予高危门诊患者高滴度Covid-19恢复期血浆不能降低患者疾病进展风险。

对于老年和患有某些疾病的新冠肺炎患者,2019冠状病毒病(Covid-19)可导致非常严重甚至致命的并发症。虽然疫苗降低了新冠肺炎感染和发展为重症的风险,但其治疗手段仍十分有限。通过输注Covid-19新近康复患者的恢复期血浆进行被动免疫是治疗新冠肺炎的潜在策略。近日研究人员开展临床研究,评估患病初期输注恢复期血浆对预防Covid-19高危患者疾病进展的效果。

在这项随机、多中心、单盲试验中,在门诊接受治疗的Covid-19患者接受高滴度的新冠肺炎康复患者恢复期血浆或安慰剂。参与研究的新冠肺炎患者年龄在50岁以上或存在至少1种重症风险因素,所有患者在症状出现后7天内就诊,病情稳定。研究的主要终点为15天内疾病进展,定义为全因住院、紧急护理或死亡。次要终点包括贯序量表评分最差、30天内无医疗干预天数以及全因死亡。

511名患者参与研究,平均年龄54岁,症状出现到治疗时间平均为4天,其中257人接受恢复期血浆治疗,254人接受安慰剂。康复患者捐献的恢复期血浆中SARS-CoV-2病毒中和抗体的平均滴度为1:641。恢复期血浆组77人出现疾病进展,而对照组81人(30.0% vs 31.9%,风险差异=1.9%),恢复期血浆组后验优势概率为0.68。恢复期血浆组5名患者死亡,对照组1人死亡。组间患者病情最严重程度和无医疗干预天数结果相似。

组间30天后疾病严重程度差异

研究认为,在Covid-19症状出现后1周内给予高危门诊患者高滴度Covid-19恢复期血浆不能降低患者疾病进展风险。

原始出处:

Frederick K. Korley et al. Early Convalescent Plasma for High-Risk Outpatients with Covid-19. N Engl J Med,August 18,2021.

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    2021-10-31 by2009
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    2021-08-20 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2021-08-20 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1953052, encodeId=a8c7195305275, content=<a href='/topic/show?id=bafc5283ed3' target=_blank style='color:#2F92EE;'>#恢复期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52837, encryptionId=bafc5283ed3, topicName=恢复期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e2c339, createdName=by2009, createdTime=Sun Oct 31 14:42:01 CST 2021, time=2021-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765147, encodeId=3b621e6514706, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Aug 21 11:42:01 CST 2021, time=2021-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587301, encodeId=3dc9158e3013b, content=<a href='/topic/show?id=a6785283909' target=_blank style='color:#2F92EE;'>#恢复期血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52839, encryptionId=a6785283909, topicName=恢复期血浆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f73917462216, createdName=doctorzheng, createdTime=Sun Aug 22 10:42:01 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1029886, encodeId=99d51029886e2, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Aug 20 22:42:01 CST 2021, time=2021-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035733, encodeId=b8871035e3328, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Aug 20 22:42:01 CST 2021, time=2021-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1009801, encodeId=486c100980105, content=当时说血浆能治疗,我们就讨论过不可能, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210818/fb5e13970d3f4b33ad2f87e78533b788/2bf64a46b2af4889a9670b2c45628c79.jpg, createdBy=b99c5577202, createdName=仓央嘉措, createdTime=Fri Aug 20 19:51:02 CST 2021, time=2021-08-20, status=1, ipAttribution=)]
    2021-08-20 仓央嘉措

    当时说血浆能治疗,我们就讨论过不可能

    0

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