Abstract:

Objective: To explore the efficacy and safety of convalescent plasma in treatment of severe COVID-19. Methods: Clinical data, diagnosis and treatment, and follow-up of two cases of rapid progressing severe COVID-19 treated with convalescent plasma were retrospectively analyzed with review of literatures. These two patients were treated in Fuzhou Pulmonary Hospital of Fujian Province from March to April, 2020. Literatures were searched with “convalescent plasma” and “SARS-CoV-2” or “COVID-19” as the retrieval terms in PubMed database, and searched with the retrieval words of “convalescent plasma” and “COVID-19” or “new coronavirus pneumonia” in CNKI and Wanfang medical network database with the retrieval time of November 2021. Literatures of incomplete reviews and incomplete data were excluded, and well-documented literatures of restorative plasma therapy for severe and severe COVID-19 were included. The clinical data, efficacy, outcome and adverse reactions were collected, and the literature was reviewed. Results: Case 1 was 65 years old, female, with chief complaint of “cough and fever for 8 days”; Case 2 was 57 years old, male, with chief complaint of “cough, expectoration and fever for 5 days”. Both of them were diagnosed as severe COVID-19. Chest CT scan showed the progress of lung lesions in the short term. Symptoms were improved in the short term after being treated with convalescent plasma, nucleic acid turned negative, and chest CT scan showed that the lung lesions were more absorbed than before. Cases from 4 Chinese literatures and 13 English articles selected, plus 2 new coronavirus pneumonia patients in this study, were totally 6623 treated with convalescent plasma (4121 were male and 2502 were female). They aged from 18 to 99 years old, and 1595 of them died, the all-cause mortality was 24.08%. Adverse reactions were found in 1160 cases, the incidence was 17.51%; the intubation rate was 13.05% (864/6623). In the control group (without convalescent plasma treatment, n=7213), 1676 cases died, and the all-cause mortality was 23.24%; 1176 cases had adverse reactions, the incidence was 16.30%; and the intubation rate was 14.35% (1035/7213). There was no significant difference in all-cause mortality (χ²=1.372, P=0.241) and incidence of adverse reactions (χ²=3.607, P=0.058) between the two groups. However, the intubation rate was significantly lower than that in the control group, and the difference was statistically significant (χ²=4.955,P=0.026). Conclusion: Convalescent plasma is safe for COVID-19, especially for with severe or severe ones. The significance of convalescent plasma in improving the total mortality of COVID-19 patients is still controversial, but using high titer convalescent plasmas soon as possible may reduce the rate of endotracheal intubation.

Key words: Convalescent plasma, Coronavirus infections, Pneumonia,viral, Review literature as topic