Objectives: Convalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19.
Design: Open-label, parallel-arm, phase II, multicentre, randomized controlled trial.
Setting: Thirty-nine public and private hospitals across India.
Participants: Hospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air).
Intervention: Participants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm.
Main Outcome Measure: Composite of progression to severe disease (PaO2/FiO2<100) or all-cause mortality at 28 days post-enrolment.
Results: Between 22 nd April to 14 th July 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95%
CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: -0.61 to 1.83].
Interpretation: CP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres
in donors and participants may further clarify the role of CP in management of COVID-19.
Acute unintentional inhalation of paint thinner fumes resulted in serious multi-organ toxicity and death. This case strongly suggests the need to employ suitable precautionary measures while handling volatile organic solvents in a confined area.
The objective of this study was to evaluate the performance of a lateral flow antibody test for COVID-19, approved for use in India. Although many point-of-care antibody tests are available globally, they have been subjected to limited clinical validation. This has led to suboptimal outcomes in the field, where antibody tests play a significant role in tracking the immunity of individuals and communities. In this study an antibody test, ImmunoQuick that recognizes antibodies to the Nucleocapsid and Spike proteins of SARS CoV-2 was tested in 100 symptomatic patients with a positive or negative diagnosis of COVID-19, based on RT-PCR results. The overall sensitivity of the test was found to be 86.1% (95% CI: 76.4% to 92.8%) and specificity 100% (95% confidence interval: 73.5% to 100%). The sensitivity reached a peak of 95.7% with samples taken 17 days after the onset of symptoms. Overall, the sensitivity and specificity of the test are sufficient for assessing seroprevalence.
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