scholarly journals Kinetics of SARS-CoV-2 antibody responses pre- and post- COVID-19 convalescent plasma transfusion in patients with severe respiratory failure: an observational case-control study

2020 ◽  
Author(s):  
Matthew N. Klein ◽  
Elizabeth Wenqian Wang ◽  
Paul Zimand ◽  
Heather Beauchamp ◽  
Caitlin Donis ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Ecmo Support ◽  
Control Group ◽  
Severe Respiratory Failure ◽  
Before And After ◽  
Life Threatening ◽  
Antibody Titers ◽  
Similar Survival ◽  
Kinetics Of ◽  
Control Study

ABSTRACTOBJECTIVESTo investigate if COVID-19 convalescent plasma (CCP) transfusion in patients with severe respiratory failure will increase plasma levels of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibody titers while improving survival and clinical outcomes.DESIGNObservational, retrospective, control study of anti-Receptor binding domain (RBD) of SARS-CoV-2 IgG and IgM titers from serial plasma samples drawn before and after CCP administration. Clinical improvement in CCP recipients is assessed and compared to COVID-19 control patients.SETTINGPatients hospitalized with severe COVID19, United States, between April 17 and July 19, 2020PARTICIPANTS34 patients hospitalized with severe or life threatening COVID-19 and who consented and received a CCP transfusion, 95 control patients with COVID-19 not transfused with CCP. 34 out the 95 control patients were matched for age, sex, and the level of respiratory support required. Patients less than 18 years old were excluded.MAIN OUTCOME MEASURESSerial trends of anti-RBD of SARS-CoV-2 IgG and IgM titers in CCP recipients are compared to those in control patients. The primary outcome is survival at 30 days, and the secondary outcomes are length of ventilatory and/or extracorporeal membrane oxygenation (ECMO) support, length of stay (LOS) in the hospital, and LOS in the ICU.RESULTSCCP transfusion occurred in 34 patients at a median of 12 days following COVID-19 symptom onset. Immediately prior to CCP transfusion, patients median anti-RBD SARS-CoV-2 IgG and IgM titers were 1:3200 (IQR, 1:50 to 1:9600) and 1:320 (IQR, 1:40 to 1:640) respectively. Following a Loess regression analysis, the kinetics and distribution of anti-RBD of SARS-CoV-2 IgG and IgM in plasma from CCP recipients were comparable to those from a control group of 68 patients who did not receive CCP. CCP recipients presented with similar survival, similar duration on ventilatory and/or ECMO support, as well as ICU and hospital LOS, compared to a matched control group of 34 patients.CONCLUSIONIn the present study, hospitalized COVID-19 patients with severe respiratory failure transfused with CCP presented with high titers of SARS-CoV-2 IgG antibodies before transfusion and did not show improved survival at 30 days.

scholarly journals Kinetics of SARS-CoV-2 antibody responses pre-COVID-19 and post-COVID-19 convalescent plasma transfusion in patients with severe respiratory failure: an observational case–control study

2021 ◽  
pp. jclinpath-2020-207356
Author(s):  
Matthew N Klein ◽  
Elizabeth Wenqian Wang ◽  
Paul Zimand ◽  
Heather Beauchamp ◽  
Caitlin Donis ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Clinical Outcomes ◽  
Ecmo Support ◽  
Survival Duration ◽  
Severe Respiratory Failure ◽  
Loess Regression ◽  
Antibody Titres ◽  
Similar Survival ◽  
Kinetics Of ◽  
Control Study

AimsWhile the SARS-CoV-2 pandemic may be contained through vaccination, transfusion of convalescent plasma (CCP) from individuals who recovered from COVID-19 (CCP) is considered an alternative treatment. We investigate if CCP transfusion in patients with severe respiratory failure increases plasma titres of SARS-CoV-2 antibodies and improves clinical outcomes.MethodsPatients with COVID-19 (n=34) were consented for CCP transfusion and serial blood draws pretransfusion and post-transfusion. Plasma SARS-CoV-2 antireceptor binding domain (RBD) IgG and IgM titres were measured by ELISA serially, and compared with serial plasma titre levels from control patients (n=68). The primary outcome was survival at 30 days, and secondary outcomes were length of ventilator and/or extracorporeal membrane oxygenation (ECMO) support, length of stay (LOS) in the hospital and in the intensive care unit (ICU). Outcomes were compared with matched control patients (n=34). Kinetics of antibodies and clinical outcomes were compared using LOess regression and ORs, respectively.ResultsPrior to CCP transfusion, 74% of patients were anti-RBD seropositive for IgG (median 1:3200), and 81% were anti-RBD IgM seropositive (median 1:320), while 16% were seronegative. The kinetics of antibody titres in CCP recipients were similar to controls. CCP recipients presented with similar survival, duration on ventilatory and/or ECMO support, as well as ICU and hospital LOS compared with controls.ConclusionsCCP transfusion did not increase the kinetics of SARS-CoV2 antibodies and did not result in improved clinical outcomes in patients with COVID-19 with severe respiratory failure, suggesting that CCP may not be indicated in this category of patients.

Infants With Severe Respiratory Failure and Persistance of the Fetal Circulation, Without Hyperventilation

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 379-379
Author(s):  
DANIEL L. LEVIN
Keyword(s):  
Respiratory Failure ◽  
Treatment Plan ◽  
General Treatment ◽  
Control Group ◽  
Prospective Analysis ◽  
Severe Respiratory Failure ◽  
Fetal Circulation

To the Editor.— I just finished reading the article by Wung et al Pediatrics 1985;76:488-494). I was quite surprised at the publication of this article. There are several problems that make it such that I question its appropriateness in the article section of Pediatrics. The most important objection is that it is a retrospective collection of patients who were treated by some general treatment plan with no prospective analysis or control group. The data collected are dubious at best; for example, the authors do not state where the O2 samples were drawn and they do not define what they mean by the patient's oxygenation being improved with tolazoline.

Pulmonary aspergilloma: from classification to management

2019 ◽  
Vol 28 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Hicham Harmouchi ◽  
Rabiou Sani ◽  
Ibrahim Issoufou ◽  
Marouane Lakranbi ◽  
Yassine Ouadnouni ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Respiratory Failure ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Severe Respiratory Failure ◽  
Poor General Condition ◽  
Thoracic Computed Tomography ◽  
Life Threatening ◽  
Pulmonary Aspergilloma ◽  
Pulmonary Cavity

Pulmonary aspergilloma is a form of aspergillosis characterized by the colonization of a preexisting pulmonary cavity, most often of tuberculosis origin. Clinical symptoms are predominately hemoptysis that can be life-threatening, and thoracic computed tomography can distinguish simple from complex pulmonary aspergilloma. The best therapeutic option remains surgery which allows surgical resection of the mycetoma and the underlying cavity. Nonsurgical treatment is performed in inoperable patients because of severe respiratory failure or a poor general condition.

Nonventilatory strategies for patients with life-threatening 2009 H1N1 influenza and severe respiratory failure

2010 ◽  
Vol 38 ◽  
pp. e74-e90 ◽  
Author(s):  
Lena M. Napolitano ◽  
Pauline K. Park ◽  
Krishnan Raghavendran ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
H1n1 Influenza ◽  
Severe Respiratory Failure ◽  
Life Threatening ◽  
2009 H1n1

scholarly journals Performance Evaluation of the Siemens SARS-CoV-2 Total Antibody and IgG Antibody Test

2021 ◽  
Author(s):  
Lisa Florin ◽  
Karel Maelegheer ◽  
Wouter Vandewal ◽  
Dirk Bernard ◽  
Johan Robbrecht
Keyword(s):  
Antibody Test ◽  
Control Group ◽  
Igg Antibody ◽  
Antibody Assays ◽  
Antibody Titers ◽  
Polymerase Chain ◽  
Kinetics Of ◽  
Antibody Tests ◽  
Positive Controls

Abstract Objective In this study, the performance of 2 commercially available SARS-CoV-2 antibody assays is evaluated. Methods The Siemens SARS-CoV-2 Total (COV2T) and IgG (COV2G) antibody tests were evaluated on a Siemens Atellica IM1300 analyzer. Imprecision was assessed with the CLSI EP15 protocol using positive controls. Ninety control group specimens were analyzed for specificity, and 175 specimens from 58 patients with polymerase chain reaction–confirmed SARS-CoV-2 were measured for the sensitivity and kinetics of the antibody response. Results Within-run and total imprecision were acceptable for both assays. Both tests showed a specificity of 100%. Sensitivity earlier in the disease state was greater for the COV2T assay than for the COV2G assay, but sensitivity >14 days after onset of symptoms approached 100% for both. For all patients, antibody titers remained above the seroconversion cutoff for all follow-up specimens. Conclusion This study shows acceptable performance for both the Siemens COV2T and COV2G test, although seroconversion occurs earlier with the COV2T test.

scholarly journals Is there a link between pre-existing antibodies acquired due to childhood vaccinations or past infections and COVID-19? A case control study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10910
Author(s):  
Bilge Sumbul ◽  
Hilmi Erdem Sumbul ◽  
Ramazan Azim Okyay ◽  
Erdinç Gülümsek ◽  
Ahmet Rıza Şahin ◽  
...  
Keyword(s):  
Disease Severity ◽  
Bordetella Pertussis ◽  
Case Control Study ◽  
Case Control ◽  
Immune Memory ◽  
Control Group ◽  
Protective Function ◽  
Vaccine Antigens ◽  
Antibody Titers ◽  
Control Study

Background There is growing evidence indicating that children are less affected from COVID-19. Some authors speculate that childhood vaccinations may provide some cross-protection against COVID-19. In this study, our aim was to compare the circulating antibody titers for multiple childhood vaccine antigens, as an indicator of the state of immune memory between patients with COVID-19 and healthy controls, with a specific aim to identify the association between disease severity and antibody titrations which may indicate a protective function related to vaccine or disease induced memory. Methods This study is a case-control study including 53 patients with COVID-19 and 40 healthy volunteers. COVID-19 severity was divided into three groups: asymptomatic, mild and severe. We measured the same set of antibody titers for vaccine antigens, and a set of biochemical and infection markers, in both the case and control groups. Results Rubella (p = 0.003), pneumococcus (p = 0.002), and Bordetella pertussis (p < 0.0001) titers were found to be significantly lower in the case group than the control group. There was a significant decline in pneumococcus titers with severity of disease (p = 0.021) and a significant association with disease severity for Bordetella pertussis titers (p = 0.014) among COVID patients. Levels of AST, procalcitonin, ferritin and D-dimer significantly increased with the disease severity. Discussion Our study supports the hypothesis that pre-existing immune memory, as monitored using circulating antibodies, acquired from childhood vaccinations, or past infections confer some protection against COVID-19. Randomized controlled studies are needed to support a definitive conclusion.

scholarly journals A prospective study of N-acetylcysteine treatment in drug-induced fulminant hepatic failure

2019 ◽  
Vol 8 (5) ◽  
pp. 1000
Author(s):  
Tauseef Nabi ◽  
Nadeema Rafiq ◽  
Quratul Ain Arifa
Keyword(s):  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Control Group ◽  
Rapid Progression ◽  
Drug Induced ◽  
Life Threatening ◽  
Baseline Characteristics ◽  
A Prospective Study ◽  
Tuberculosis Therapy ◽  
Control Study

Background: Acute liver failure (ALF) is a rare but severe, life-threatening, complex, multisystemic gastroenterological emergency. Its rapid progression and high mortality demand early diagnosis and expert management. Drug-induced ALF (DI-ALF) remains the uncommon cause of ALF in India. To date, there is no established treatment for DI-ALF other than liver transplantation and little is known about the use of N-acetylcysteine (NAC) in DI-ALF. A prospective case-control study was carried with the aim to determine the effect of NAC on mortality of DI-FHF patients and also to evaluate the safety and efficacy of NAC use.Methods: A total of 18 patients with a diagnosis of DI-FHF were included in the study. 10 patients received NAC infusion for 72 hours whereas the control group received placebo. The variables evaluated were demographic, signs and symptoms, biochemical parameters, outcome and length of hospital stay.Results: Out of 18 DI-FHF patients, 13 (72.2%) had anti-tuberculosis therapy (ATT) induced FHF and 5 (27.8%) patients had ayurvedic induced FHF. The two groups were comparable for the various baseline characteristics (age, INR, alanine aminotransferase, creatinine, albumin, grade of encephalopathy, etc.). The mortality decreased to 20% with the use of NAC versus 75% in the control group (P=0.023). Use of NAC was associated with a shorter length of hospital stay of survived patients (P=0.043). Moreover, the overall survival was improved by NAC (P=0.023) in DI-FHF. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF use (P=0.019).Conclusions: Author recommended the use of NAC along with conventional treatments in patients with DI-FHF in non-transplant centers while awaiting referrals. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF with NAC administration and its use was safe.

Successful use of extracorporeal membrane oxygenation to treat severe respiratory failure in a pediatric patient with a scald injury

1998 ◽  
Vol 18 (6) ◽  
pp. 63-72 ◽  
Author(s):  
T Hilt ◽  
DF Graves ◽  
JM Chernin ◽  
CA Angel ◽  
DN Herndon ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Blood Product ◽  
Ecmo Support ◽  
Severe Respiratory Failure ◽  
Exclusion Criteria ◽  
Scald Injury

If ECMO is to be used effectively in pediatric patients, specifically in those with burns, the candidates must be chosen with care. Unlike the situation in neonates, when ECMO is being considered for use in a pediatric patient, no clear set of inclusion or exclusion criteria exists. Evaluation of a pediatric patient for ECMO support is largely based on an assessment of the patient's condition and a center's previous experience with pediatric ECMO. The data that are available through ELSO indicate that survival decreases as the number of days a patient receives mechanical ventilation before the initiation of ECMO increases. The effect of burns on patients' outcomes is unknown. Age, duration of mechanical ventilation, and excision with allografting or homografting of the burns should all be considered before the patient is offered ECMO support. The remaining prognostic signs--duration of ECMO support, frequency of complications, and blood product requirements--are available only after the ECMO course is under way or completed. The success of our center and others in using ECMO to treat respiratory failure associated with burns shows that some patients with burns may benefit from ECMO. Unfortunately, no specific set of criteria exists that would enable ECMO centers to differentiate good candidates from poor ones and thus be able to offer ECMO support with confidence in its benefit for the patient.

Sign in / Sign up

Export Citation Format

Share Document