Background
The efficacy of early treatment with convalescent plasma in patients with COVID-19 is debated. Nothing is known about the potential effect of other plasma components other than anti-SARS-CoV-2 antibodies.
Methods
To determine whether convalescent or standard plasma would improve outcomes for adults in early phase of Covid19 respiratory impairment we designed this randomized, three-arms, clinical trial (PLACO COVID) blinded on interventional arms that was conducted from June 2020 to August 2021. It was a multicentric trial at 19 Italian hospitals. We enrolled 180 hospitalized adult patients with COVID-19 pneumonia within 5 days from the onset of respiratory distress. Patients were randomly assigned in a 1:1:1 ratio to standard of care (n = 60) or standard of care + three units of standard plasma (n = 60) or standard of care + three units of high-titre convalescent plasma (n = 60) administered on days 1, 3, 5 after randomization. Primary outcome was 30-days mortality. Secondary outcomes were: incidence of mechanical ventilation or death at day 30, 6-month mortality, proportion of days with mechanical ventilation on total length of hospital stay, IgG anti-SARS-CoV-2 seroconversion, viral clearance from plasma and respiratory tract samples, and variations in Sequential Organ Failure Assessment score. The trial was analysed according to the intention-to-treat principle.
Results
180 patients (133/180 [73.9%] males, mean age 66.6 years [IQR 57–73]) were enrolled a median of 8 days from onset of symptoms. At enrollment, 88.9% of patients showed moderate/severe respiratory failure. 30-days mortality was 20% in Control arm, 23% in Convalescent (risk ratio [RR] 1.13; 95% confidence interval [CI], 0.61–2.13, P = 0.694) and 25% in Standard plasma (RR 1.23; 95%CI, 0.63–2.37, P = 0.544). Time to viral clearance from respiratory tract was 21 days for Convalescent, 28 for Standard plasma and 23 in Control arm but differences were not statistically significant. No differences for other secondary endpoints were seen in the three arms. Serious adverse events were reported in 1.7%, 3.3% and 5% of patients in Control, Standard and Convalescent plasma arms respectively.
Conclusions
Neither high-titer Convalescent nor Standard plasma improve outcomes of COVID-19 patients with acute respiratory failure.
Trial Registration Clinicaltrials.gov Identifier: NCT04428021. First posted: 11/06/2020
Recently, the built heritage sector has witnessed an increase demand for 3D models of historical sites mainly due to the widespread of new technologies in buildings' surveying. Although these technologies have been credited for enabling highly detailed 3D modelling of the built heritage, their implementation is still so complex and costly. This research aims to explore the possibility of implementing new low-cost digital acquisition technologies and modelling techniques as an alternative to the existing expensive ones in terms of level of detail (LOD), as an attempt to enable lowskilled users in simplified environment, which are faced paced leaning milieus in education, places with high constraints, or developing countries, to practically learn about their built heritage; consequently, contribute to its preservation. To achieve this purpose, the most diffused SFM and laser scanning open-source packages were first cross-compared using web-content analysis data collection method. Afterwards, the best programme from each category namely; Autodesk 123D catch and Reconstructme, accompanied with Canon D550 camera and Xbox Kinect, respectively, were intensively evaluated through an experiment. The analysis of the findings has suggested that low-cost close-range photogrammetry can replace laser scanning when there is a lack of funding and time.
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