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- Anticoid blood plasma does not help patients on mechanical ventilation - conclusions of Russian doctors
Video: Anticoid Blood Plasma Does Not Help Patients On Mechanical Ventilation - Conclusions Of Russian Doctors
Anticoid blood plasma does not help patients on mechanical ventilation - conclusions of Russian doctors
Russian doctors conducted a randomized prospective study of the effectiveness of the use of blood plasma from recovered patients with the participation of 86 patients. The conclusions are contradictory: anticoid plasma reduces the mortality of severe and moderately severe patients who breathe on their own, but cannot save patients on mechanical ventilation.
Photo: Jason Hargrove / Flickr
The study was carried out by specialists from the Federal Medical and Biological Agency, Research Institute of Pulmonology, FMBA, Institute of Molecular Biology named after V.A. Engelhardt RAS and the FMBA Blood Center. The doctors published the results of their work as a preprint in the scientific journal Clinical Practice.
For the study, 146 potential donors of anticoid plasma with a high titer of antibodies that neutralize the SARS-CoV-2 virus were selected, and 86 patients who were divided into two groups. The first group included 20 patients in extremely serious condition who were on mechanical ventilation, the second - 66 patients with moderate or severe COVID-19 who breathed on their own. Patients of the second group were randomized into two cohorts in a 2: 1 ratio, they received different types of plasma - immune and non-immune.
“The use of convalescent plasma in patients with COVID-19 in an extremely serious condition against the background of acute respiratory failure and mechanical ventilation did not affect the outcome of the disease. Mortality in this group was 60%, which corresponded to the lethality of patients in the control group, who were on mechanical ventilation,”the doctors write.
In the second group, the results were more encouraging, clinical improvement was noted in 75% and 51%, respectively. Of the 46 people who received anticonvulsant plasma, artificial ventilation was required for three, two of them died. One of the deceased had myeloid leukemia, the second, against the background of a severe course of COVID-19 after plasma administration, developed pulmonary edema. In the group that received non-immune plasma, mechanical ventilation was also required for three patients, two died.
“The hospital mortality in the group that received convalescent plasma was 4.3%, which is significantly lower than the total hospital mortality in our hospital, determined for all completed cases (6.73%), and more than two times lower than the mortality in the retrospectively estimated control group”, - noted the authors of the study.
Doctors concluded that blood plasma from COVID-19 patients is not a panacea, but can be effective in increasing the survival rate of patients who do not require mechanical ventilation. The authors recognized the safety of this method of treatment as limited.
Similar results were obtained at the end of May by New York doctors who compared the condition of 39 patients who had a severe course of COVID-19 and received plasma with patients who were treated with other methods.
The study found that mortality in the "plasma" group was 12.8%, in the control group - 24.4%. According to doctors, this difference was not statistically significant, but when studying the needs of patients in oxygen, the results of treatment in patients who received plasma were much better. The data obtained showed that plasma does not increase the survival rate of ventilated patients, but helps non-intubated patients to recover.
“At least we've found out there is some benefit to convalescent plasma,” said Mount Sinai virologist Nicole Bouvier.
Scientists warn that plasma treatment may not be a panacea even if proven to be effective, because there may not be enough donors. The volume of collected plasma, depending on the weight of the donor, ranges from 690 to 880 milliliters - this is enough for one or two patients. In addition, the donor's blood type must match that of the recipient.
The plasma transfusion procedure also carries many health risks for the patient. Pathogenic microorganisms can enter the recipient's blood, which can cause acute damage to the lungs, or the body may not adapt to the added blood volume. In both cases, there is a risk of death.
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