Convalescent plasma treatment for SARS-CoV-2 infected high-risk patients: a matched pair analysis to the LEOSS cohort

Freise, Noemi F.; Gliga, Smaranda; Fischer, Johannes C.; Lübke, Nadine; Lutterbeck, Matthias; Schöler, Miriam; Bölke, Edwin; Orth, Hans Martin; Feldt, Torsten; Roemmele, Christoph; Wilke, Dominik; Schneider, J; Wille, Kai; Hohmann, Christian; Strauß, Richard; Hower, Martin; Ruf, Andreas; Schubert, Jöerg; Isberner, Nora; Stecher, Melanie; Pilgram, Lisa; Vehreschild, Jörg Janne; With, Katja de; Spinner, Christoph D.; Lanznaster, Julia; Beutel, Gernot; Jung, Norma; Göpel, Siri; Westhoff, Timm H.; Hohenstein, Bernd; Rothfuss, Katja; Rieg, Siegbert; Ruethrich, Maria Madeleine; Rupp, Jan; Hanses, Frank; Luedde, Tom; Jensen, Björn

doi:10.1038/s41598-022-23200-1

Cited by 3 publications

(1 citation statement)

References 44 publications

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“… Long-term COs or the risk of ARIs is not increased by COVID-19 CP, making it a safe intervention. Noemi F. Freise et al 146 Analysis of the HR SARS-CoV-2 LEOSS cohort of patients receiving CPT using matched pairs (ORA) RS analysis 55 COVID-19 patients who are in hospitals 220 patients who received or did not get CP from the LEOSS-infected patients underwent an MPA (1:4). The overall intra-hospital DR was 41.8% (23/55), while the ISARIC-4C- Score predicted an MR of 26% (Range 0.3–59.1%).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

Kandula¹,

Tuji²,

Gudeta³

et al. 2023

JBM

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Worldwide pandemic with coronavirus disease-2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As November 2, 2022, World Health Organization (WHO) received 628,035,553 reported incidents on COVID-19, with 6,572,800 mortalities and, with a total 12,850,970,971 vaccine doses have been delivered as of October 31, 2022. The infection can cause mild or self-limiting symptoms of pulmonary and severe infections or death may be caused by SARS-CoV-2 infection. Simultaneously, antivirals, corticosteroids, immunological treatments, antibiotics, and anticoagulants have been proposed as potential medicines to cure COVID-19 affected patients. Among these initial treatments, COVID-19 convalescent plasma (CCP), which was retrieved from COVID-19 recovered patients to be used as passive immune therapy, in which antibodies from cured patients were given to infected patients to prevent illness. Such treatment has yielded the best results in earlier with preventative or early stages of illness. Convalescent plasma (CP) is the first treatment available when infectious disease initially appears, although few randomized controlled trials (RCTs) were conducted to evaluate its effectiveness. The historical record suggests with potential benefit for other respiratory infections, as coronaviruses like Severe Acute Respiratory Syndrome-CoV-I (SARS-CoV-I) and Middle Eastern Respiratory Syndrome (MERS), though the analysis of such research is constrained by some non-randomized experiments (NREs). Rigorous studies on CP are made more demanding by the following with the immediacy of the epidemics, CP use may restrict the ability to utilize it for clinical testing, non-homogenous nature of product, highly decentralized manufacturing process; constraints with capacity to measure biologic function, ultimate availability of substitute therapies, as antivirals, purified immune globulins, or monoclonal antibodies. Though, it is still not clear how effectively CCP works among hospitalized COVID-19 patients. The current review tries to focus on its efficiency and usage in clinical scenarios and identifying existing benefits of implementation during pandemic or how it may assist with future pandemic preventions.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

Kandula¹,

Tuji²,

Gudeta³

et al. 2023

JBM

View full text Add to dashboard Cite

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Trajectories and predictive significance of inflammatory parameters for clinical outcome in COVID–19 patients treated with tocilizumab

Killer,

Gliga,

Massion

et al. 2024

Infection

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Purpose The IL-6 receptor inhibitor tocilizumab reduces mortality and morbidity in severe cases of COVID-19 through its effects on hyperinflammation and was approved as adjuvant therapy. Since tocilizumab changes the levels of inflammatory markers, we aimed to describe these changes in patients treated with tocilizumab, analyse their value in predicting death and bacterial superinfection and determine their influence on mortality rates. Methods A retrospective analysis of 76 patients who were treated with tocilizumab for severe COVID-19 in 2020 and 2021 was conducted. Inflammatory markers (IL-6, C-reactive protein (CRP), procalcitonin) were documented before and up to seven days after tocilizumab administration. Results The overall mortality was 25% and 53.8% in patients who required invasive respiratory support. Deceased patients had higher baseline IL-6 (p = 0.026) and peak IL-6 levels after tocilizumab vs those who survived (p < 0.0001). A peak IL-6 value > 1000 pg/dl after tocilizumab administration was a good predictor of mortality (AUC = 0.812). Of the deceased patients 41.1% had a renewed CRP increase after an initial decrease following tocilizumab administration, compared to 7.1% of the surviving patients (p = 0.0011). Documented bacterial superinfections were observed in 35.5% (27/76) of patients, of whom 48.1% (13/27) died. Conclusion CRP-decline and IL-6 increase after tocilizumab treatment occurs regularly. An increase of IL-6 levels exceeding tenfold of baseline IL-6 levels, an absolute peak of 1000 pg/ml or a renewed increase of CRP are associated with higher mortality. Suppressed CRP synthesis can impede the diagnosis of bacterial superinfections, thus increasing the risk for complications.

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Prophylactic and early outpatient treatment of COVID-19 in patients with kidney disease: considerations from the Immunonephrology Working Group of the European Renal Association (ERA-IWG)

Hilhorst

Bemelman

Bruchfeld

et al. 2023

Nephrology Dialysis Transplantation

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The SARS-CoV-2 pandemic led to rapid vaccine development and large global vaccination schemes. However, patients with immune-mediated kidney disease, chronic kidney diseases and kidney transplant recipients show high non-response rates to vaccination despite more than 3 vaccinations and, consequently, reduced viral clearance capacity when infected while receiving certain immunosuppressants, carrying an elevated risk for COVID-19 related morbidity and mortality. SARS-CoV-2 evolution has been characterized by the emergence of novel variants and spike mutations contributing to waning efficacy of neutralizing antibodies. To this end, the therapeutic field expands from vaccination towards a combined approach of immunization, pre-exposure prophylaxis and early post-exposure treatment using direct-acting antivirals and neutralizing monoclonal antibodies to treat early in the disease course and avoid hospitalization. This expert opinion paper from the Immunonephrology Working Group (IWG) of the European Renal Association (ERA) summarizes available prophylactic and/or early treatment options (i.e. neutralizing monoclonal antibodies and direct-acting antivirals) of SARS-CoV-2 infected patients with immune-mediated kidney disease, chronic kidney disease and kidney transplant recipients.

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Convalescent plasma treatment for SARS-CoV-2 infected high-risk patients: a matched pair analysis to the LEOSS cohort

Cited by 3 publications

References 44 publications

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

Trajectories and predictive significance of inflammatory parameters for clinical outcome in COVID–19 patients treated with tocilizumab

Prophylactic and early outpatient treatment of COVID-19 in patients with kidney disease: considerations from the Immunonephrology Working Group of the European Renal Association (ERA-IWG)

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