Background
Older patients, frequently with multiple comorbidities, have a high mortality from COVID-19 infection. Convalescent plasma (CP) is a therapeutic option for these patients. Our objective is to retrospectively evaluate the efficacy and adverse events of CP treatment in this population group.
Methods
Forty one patients over 80 years old with COVID-19 pneumonia received CP added to standard treatment, 51.2% with high anti-SARS-CoV-2 IgG titers and 48.8% with low titers. Median time between the onset of symptoms and the infusion of plasma was 7 days (IQR 4–10). A similar group of 82 patients who received only standard treatment, during a period in which CP was not available, were selected as a control group.
Results
In-hospital mortality was 26.8% for controls and 14.6% for CP patients (P = 0.131) and ICU admission was 8.5% for controls and 4.9% for CP patients (P = 0.467). Mortality tended to be lower in the high-titer group (9.5%) than in the low-titer group (20%), and in patients transfused within the first 7 days of symptom onset (10%) than in patients transfused later (19.1%), although the differences were not statistically significant (P = 0.307 and P = 0.355 respectively). There was no difference in the length of hospitalization. No significant adverse events were associated with CP treatment.
Conclusions
Convalescent plasma treatment in patients over 80 years old with COVID-19 pneumonia was well tolerated but did not present a statistically significant difference in hospital mortality, ICU admission, or length of hospitalization. The results should be interpreted with caution as only half the patients received high-titer CP and the small number of patients included in the study limits the statistical power to detect significant differences.
Trial registration
CEIm Cantabria # 2020.127.
Introducción: La povidona yodada y el peróxido de hidrógeno podrían ser eficaces contra el SARS-CoV-2.
Métodos: Estudio observacional de seguimiento prospectivo (EPA-AS) en 88 pacientes (43±17 años, 55% varones) con SARS-CoV-2 en muestras nasofaríngeas (RT-PCR). 31 recibieron enjuagues/gargarismos con povidona yodada cada 8 horas dos días consecutivos, 17 con la misma pauta de peróxido de hidrógeno, y 40 controles sin enjuagues. Se repitió PCR a 3, 11 y 17 días.
Resultados: Tras la intervención no hubo diferencias en la carga viral: povidona yodada (4,3±2,7 copias/ml), peróxido de hidrógeno (4,6±2,9 copias/ml; p=0,40), controles (4,4±3,0 copias/ml). El porcentaje de pacientes con 2ª PCR negativa fue 27% povidona yodada, 23% peróxido de hidrógeno y 32% controles; en la 3ª PCR 62%, 54% y 58% respectivamente y en la 4ª PCR, 81%, 75% y 81%.
Conclusión: Nuestros resultados no apoyan la utilidad de los enjuagues de estos dos antisépticos en pacientes con COVID-19.
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