Comparison of hematological and biochemical parameters in COVID-19 pneumonia patients before and after convalescent plasma (CP) treatment
COVID-19 pneumonia and convalescent plasma treatment
Keywords:COVID-19, Convalescent plasma, CRP, d-dimer, WBC
Background/Aim: Convalescent plasma (CP) therapy, which includes processing and administering antibody-rich plasma from recovered patients to sick patients, is used for passive immunity in COVID-19 pneumonia patients in addition to antivirals and antibiotics. This study aimed to assess whether CP treatment significantly affects hyperviscosity and COVID-19 prognosis-related blood parameters.
Methods: This study was a single-center retrospective cohort study. Ninety-seven patients with COVID-19 polymerase chain reaction (PCR)-positive results and pneumonia observed on thoracic computed tomography (CT) were included. Patients’ ferritin, d-dimer, C-reactive protein (CRP), and complete blood count levels before and after CP administration were compared.
Results: Ferritin, d-dimer, white blood cell (WBC), neutrophil, and plateletcrit (PCT) levels and the platelet distribution width (PDW) were significantly higher and there was a significant decrease in the CRP level after CP treatment compared to before CP (P < 0.05). Ferritin, d-dimer, and CRP values measured after CP were higher in deceased patients than in survivors (P = 0.001, P = 0.007, and P < 0.001, respectively)
Conclusion: Ferritin, d-dimer, WBC, and neutrophil levels, which we expected to decrease on the basis of the COVID-19 prognosis, unfortunately increased, and only CRP levels decreased. However, we found that these increases were more pronounced in patients who died. Considering these prognostic factors, the findings of our study suggest that CP treatment has no effect on the COVID-19 disease course and may lead to a worse prognosis.
Ge Dhama K, Sharun K, Tiwari R. Dadar M, Malik YS, Singh KP, et al. COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics. Hum Vaccin Immunother. 2020 Jun 2;16(6):1232–8. doi: 10.1080/21645515.2020.1735227. DOI: https://doi.org/10.1080/21645515.2020.1735227
Soo YO, Cheng Y, Wong R, Hiu DS, Lee CK, Tsang KK, et al. Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients. Clin Microbiol Infect. 2004 Jul;10(7):676–8. doi: 10.1111/j.1469-0691.2004.00956.x. DOI: https://doi.org/10.1111/j.1469-0691.2004.00956.x
Huang S, Shen C, Xia C, Huang X, Fu Y, Tian L. A retrospective study on the effects of convalescent plasma therapy in 24 patients diagnosed with COVID-19 pneumonia in February and March 2020 at 2 centers in Wuhan, China. Med Sci Monit. 2020 Dec 2;26:e928755. doi: 10.12659/MSM.928755. DOI: https://doi.org/10.12659/MSM.928755
Food and Drug Administration Coronavirus (COVID-19) Update: Daily Roundup. Website: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-daily-roundup-march-24-2020 (accessed 24 March 2020).
Garraud O, Heshmati F, Pozzetto B, Lefrere F, Girot R, Saillol A, et al. Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow. Transfus Clin Biol 2016;23:39–44. doi: 10.1016/j.tracli.2015.12.003. DOI: https://doi.org/10.1016/j.tracli.2015.12.003
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA 2020;323:1582-9. doi: 10.1001/jama.2020.4783. DOI: https://doi.org/10.1001/jama.2020.4783
Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J, et al. Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A randomized Clinical Trial. JAMA. 2020 Aug 4;324(5):460-70. doi: 10.1001/jama.2020.10044. DOI: https://doi.org/10.1001/jama.2020.12607
Truong AD, Auld SC, Barker NA, Friend S, Wynn AT, Cobb J, Sniecinski RM, et al. Therapeutic plasma Exchange for COVID-19 associated hyperviscosity. Transfusion. 2021 Apr; 61(4):1029-34. doi: 10.1111/trf.16218. DOI: https://doi.org/10.1111/trf.16218
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw F-M, Lim WS, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: A systematic review and exploratory meta-analysis. J Infect Dis Jan 1;211(1):80-90. doi: 10.1093/infdis/jiu396. DOI: https://doi.org/10.1093/infdis/jiu396
Rojas M, Monsalve DM, Pacheco Y, Acosta-Ampudia Y, Ramírez-Santana C, Ansari AA, et al. Ebola virus disease: An emerging and re-emerging viral threat. J Autoimmun 2020;106:102375. doi: 10.1016/j.jaut.2019.102375. DOI: https://doi.org/10.1016/j.jaut.2019.102375
Planitzer CB, Modrof J, Kreil TR. West Nile virus neutralization by US plasma-derived immunoglobulin products. J Infect Dis 2007 Aug 1;196(3):435-40. doi: 10.1086/519392. DOI: https://doi.org/10.1086/519392
Polat E, Demir MC. Platelet Indices' Usefulness in Determining whether Patients with COVID-19 Should be Treated as an Outpatient or Inpatient: a Retrospective Study. Clin. Lab. 2021 Jul 1;67(7). doi: 10.7754/Clin.Lab.2020.201144. PMID: 34258979. DOI: https://doi.org/10.7754/Clin.Lab.2020.201144
Abolghasemi H, Eshghi P, Cheraghali AM, Imani Fooladi AA, Bolouki Moghaddam F, Imanizadeh S, et al. Clinical Efficacy of Convalescent Plasma for Treatment of COVID-19 infections: Results of a Multicenter Clinical Study. Transfus Apher Sci. 2020 Oct;59(5):102875. doi: 10.1016/j.transci.2020.102875. DOI: https://doi.org/10.1016/j.transci.2020.102875
Gemici A, Bilgen H, Erdoğan C, Kansu A, Olmuşçelik O, Beköz HS, et al. A Single Center Cohort of 40 Severe COVID-19 Patients Who Were Treated With Convalescent Plasma. Turk J Med Sci. (2020) Dec 17;50(8):1781-5. doi: 10.3906/sag-2009-77. DOI: https://doi.org/10.3906/sag-2009-77
Zhao J, Yang Y, Huang H, Li D, Gu D, Lu X, et al. Relationship Between the ABO Blood Group and the COVID-19 Susceptibility. Clin Infect Dis. 2021 Jul 15;73(2):328-31. doi: 10.1093/cid/ciaa1150. DOI: https://doi.org/10.1093/cid/ciaa1150
AbdelMassih AF, Mahrous R, Taha AF, Saud A, Osman A, Kamel B, et al. The Potential Use of ABO Blood Group System for Risk Stratification of COVID-19. Med Hypotheses 2020 Dec;145:110343. doi: 10.1016/j.mehy.2020.110343. DOI: https://doi.org/10.1016/j.mehy.2020.110343
O’Donnell MR, Grinsztejn B, Cummings MJ, Justman JE, Lamb MR, Eckhardt CM, et al. A Randomized double-blind controlled trial of convalescent plasma in adults with severe COVID-19. J Clin Invest. 2021 Jul 1;131(13):e150646. doi: 10.1172/JCI150646. DOI: https://doi.org/10.1172/JCI150646
Simonovich VA, Burgos Pratx LD, Scibona P, Beruto MV, Vallone MG, Vázquez C, et al. A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia. N Engl J Med. 2021;384:619-29. doi: 10.1056/NEJMoa2031304. DOI: https://doi.org/10.1056/NEJMoa2031304
Bégin P, Callum J, Jamula E, Cook R, Heddle NM, Tinmouth A, et al. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nat Med. 2021 Nov;27(11):2012-24. doi: 10.1038/s41591-021-01488-2. DOI: https://doi.org/10.1038/s41591-021-01488-2
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci USA. 2020 Apr 28;117(17):9490-6. doi: 10.1073/pnas.2004168117. DOI: https://doi.org/10.1073/pnas.2004168117
Ertürk MA, Sarici A, Berber İ, Kuku İ, Kaya E, Özgül M. Life-saving Effect of Convalescent Plasma Treatment in COVID-19 Disease: Clinical Trial From Eastern Anatolia. Transfus Apher Sci. 2020 Oct;59(5):102867. doi: 10.1016/j.transci.2020.102867. DOI: https://doi.org/10.1016/j.transci.2020.102867
Atlas A, Altay N, Karahan MA, Pehlivan VF, Pehlivan B, Duran E, et al. Neutrophil-to-lymphocyte and fibrinogen-to-albumin ratios may be indicators of worse outcomes in ICU patients with COVID-19. J Surg Med. 2021;5(6):623-7. DOI: https://doi.org/10.28982/josam.930254
Turkish Health Ministry. Guidance To Covid-19 (SARS Cov2 Infection) [Online]. Website: https://covid19.saglik.gov.tr/TR-66301/covid-19-rehberi.html (accessed 24 March 2020).
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