Anaphylactic Shock in a Pregnant Patient With Covid-19 in the Setting of Convalescent Plasma Transfusion

Mallari, Margaret; Sompalli, Sreeja; Noormohammad, Shaista; Malik, Ishita; Sivaraman, Sivashankar

doi:10.1016/j.chest.2020.08.893

Cited by 2 publications

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“…The evidence was dominated by one NRCT which accounted for 85.5% of the weight in the meta-analysis. However, some studies reported that CP treatment was significantly associated with improved oxygen saturation during the first 72 hours in critically ill patients [15,37]. This meta-analysis included three RCTs and one Cross-sectional study demonstrated that CP patients were benefited from reduced length of hospital in about 2 days.…”

Section: Discussionmentioning

confidence: 86%

“…A meta-analysis that included 1060 patients from 4 Randmomised Control Studies (RCTs), reported that CP therapy had not produced significant improvements in mortality rate and length of hospital stay compared to standard treatment and placebo [14]. Small clinical trials and a national access program indicated that convalescent plasma may help to reduce the severity of Covid-19 and shorten its duration [15].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Convalescent Plasma Transfusion Therapy in Moderate to Critically Ill Covid-19 Patients: A Systematic Review and Meta-Analysis

Prudhivi

Padmasree

Swetha

et al. 2021

JPRI

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Background: Currently, Convalescent plasma (CP)is considered a favorable treatment option for moderate to critically ill Covid-19 patients. But there were very few systematic reviews focused on the effect of CP on clinical parameters. As a result, we undertook this systematic review to learn more about the safety and clinical benefits of convalescent plasma therapy over standard treatment (control). Methodology: We searched Pub Med, Embase and other bibliographic databases to find relevant articles between December 2019 and February 2021 and identified 10 relevant articles which compared CP therapy taken in addition to standard medication with the Control group(who received standard medication). Two independent reviewers examined all full-text articles and extracted the required information intoa predesigned proforma. Forest plots were drawn using RevMan v.5, a statistical tool offered by the Cochrane database to estimate the pooled effect. Results: The results of meta-analysis using a random effect model indicated a significant reduction in mortality rate in CP (about 27% risk reduction), a reduced length of hospital stay in about 2 days (Weighted Mean Difference: -2.53, 95% CI, -7.20 to -2.14, P<0.0001), less time to improve clinical symptoms in about 4 days (pooled mean; CP:10.82 days vs Control:15.14 days). C-Reactive Protein (CRP) concentration levels (mg/L) were well controlled with the control group than the CP group and significant changes in lymphocytes and D-dimer values were not observed after CP treatment. It was also found that no difference between CP transfusion and control was seen in improving the oxygen saturationlevels. Conclusion: CP transfusion can be considered safe and showed a significant reduction in mortality and possible benefits in clinical improvement. Patients on CP therapy had no significant benefits in improving inflammatory markers such as CRP, lymphocytes, D-dimer, or oxygen saturation levels over standard drug therapy, according to meta-analysis data.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Convalescent Plasma Transfusion Therapy in Moderate to Critically Ill Covid-19 Patients: A Systematic Review and Meta-Analysis

Prudhivi

Padmasree

Swetha

et al. 2021

JPRI

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Convalescent-anti-SARS-CoV-2-plasma

2020

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Convalescent-anti-SARS-CoV-2-plasma Anaphylactic shock and transfusion reaction: case report A 36-year-old woman developed anaphylactic shock and transfusion reaction during treatment with convalescent-anti-SARS-CoV-2-plasma for COVID-19 *. The pregnant woman (31 weeks gestation), presented with one week history of worsening shortness of breath, persistent cough and body aches. SARS-Cov-2 PCR test was found positive, and she was admitted with the diagnosis of acute hypoxemic respiratory insufficiency secondary to COVID-19 infection. During the hospitalisation period, she received betamethasone for fetal lung development. She was also started on convalescent-anti-SARS-CoV-2-plasma [dosage not stated; convalescent plasma]. Additionally, she received off label treatment with ceftriaxone and azithrymycin for the COVID-19 infection. However, her hypoxia continued to worsen, requiring vapotherm. Additionally, she developed anaphylactic shock (in the form of hypotension) and transfusion reaction related to the treatment with convalescent-anti-SARS-CoV-2-plasma [duration of treatment to reactions onsets]. Due to the hypotension, the woman received treatment with sodium-chloride [normal saline] bolus 1L, dexamethasone, epinephrine, diphenhydramine [Benadryl], famotidine [Pepcid] and norepinephrine [Levophed] drip. Afterwards, she underwent an emergent delivery. After delivery, she was transferred to the ICU, intubated and required pressor support. Chest X-ray revealed bilateral infiltrates. She continued to be hypoxic with poor arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) ratio requiring proning. She was also started on remdesivir. She had significantly elevated troponin levels. She was started on a heparin drip, which was later discontinued [outcomes not stated].

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Anaphylactic Shock in a Pregnant Patient With Covid-19 in the Setting of Convalescent Plasma Transfusion

Cited by 2 publications

References 0 publications

Clinical Outcomes of Convalescent Plasma Transfusion Therapy in Moderate to Critically Ill Covid-19 Patients: A Systematic Review and Meta-Analysis

Clinical Outcomes of Convalescent Plasma Transfusion Therapy in Moderate to Critically Ill Covid-19 Patients: A Systematic Review and Meta-Analysis

Convalescent-anti-SARS-CoV-2-plasma

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