Hassan Abolghasemi; Abdol Majid Cheraghali; AbbasAli ImaniFooladi; Peyman Eshghi; Mokhtar Tazik; Nariman Sadri; Farzaneh BoloukiMoghaddam; Mohammad Rezapour; sina Imanizadeh; Matin Maeini Maleki; Mohammad Hosein Ranjkesh; Hoshyar Maghsoudi; Mahtab Maghsoodlu; NasimSadat HosseiniDivkolaye; Ramezan Jafari; Behzad Einollahi; Mohamad Nikpouraghdam; Zahra Soleimani; Ali Bahramifar; Hassan Goodarzi; Nematollah JoneidiJafari; Mojtaba Sepandi; Ali Ghazvini; Seyed Mohammad Javad Hoseini; Mohammad Hadi Radfar
Volume 23, Issue 9 , 2021
Abstract
Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients.
Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 ...
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Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients.
Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients.
Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ? 20/min, blood oxygen saturation ? 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes.
Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ? 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed.
Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.
Amir Hosein Ghazale; Ali Ghazvini; Mostafa Ghanei; Ensieh Vahedi; Abolfazl Mozafari; Shideh Omidian; Mohammad Rezapour; Nafiseh Rastgoo; Fatemeh Movaseghi; Fateme Mansouri; Mohammad Ali Zohal; Maryam Gheraati; Seyed Hassan Saadat; Hassan Goodarzi; Mohammad Gholami Fesharaki; Amir Mohammad Dehghan Banadkooki; Shahrzad Saloo; Hesamodin Salou
Volume 23, Issue 6 , 2021
Abstract
Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials ...
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Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials and Methods:
This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively.
Results:
The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients.
Conclusion:
The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens.
