CONVALESCENT PLASMA TRANSFUSION FOR THE TREATMENT CRIMEAN-CONGO HEMORRHAGIC FEVER (REVIEW)

Проведен анализ литературных данных о применении плазменной терапии при лечении Конго-Крымской геморрагической лихорадки в мире. Данный обзор проведен для оценки эффективности плазменной терапии у пациентов с Конго-Крымской геморрагической лихорадкой на основе научных данных, опубликованных до настоящего времени. В последние годы отмечается определенный интерес к изучению плазменной терапии при лечении пациентов с Конго-Крымской геморрагической лихорадкой, хотя в литературе имеются лишь ограниченные данные по эффективности иммунотерапии и применения рибавирина при Конго-Крымской геморрагической лихорадке, при этом действенность рибавирина остается еще не доказанной. Однако можно предположить, что помимо противовирусных препаратов, применение плазменной терапии у больных с Конго-Крымской геморрагической лихорадкой может быть эффективным способом лечения, улучшающим клинические симптомы у пациентов, прогноз и снижающим смертность. The analysis of the literature data on the using of plasma therapy in the treatment of Congo-Crimean hemorrhagic fever was carried out. This review was conducted to evaluate the effectiveness of plasma therapy in patients with Congo-Crimean hemorrhagic fever on the basis of publications published so far. In recent years, there has been some interest in studying plasma therapy in the treatment of patients with Congo-Crimean hemorrhagic fever, although there are only limited data in the literature on the effectiveness of immunotherapy and the use of ribavirin in therapy, while the effectiveness of ribavirin remains not yet proven. However, it can be assumed that in addition to antiviral and antibacterial drugs, the use of plasma therapy in patients with Congo-Crimean hemorrhagic fever can be an effective treatment method that improves clinical symptoms in patients and reduces mortality.

Early Fresh Frozen Plasma Transfusion: Is It Associated With Improved Outcomes of Patients With Sepsis?

Background: So far, no study has investigated the effects of plasma transfusion in the patients with sepsis, especially in the terms of prognosis. Therefore, we aimed to explore the association of early fresh frozen plasma (FFP) transfusion with the outcomes of patients with sepsis.Methods: We performed a cohort study using data extracted from the Medical Information Mart for Intensive Care III database (v1.4). External validation was obtained from the First Affiliated Hospital of Wenzhou Medical University, China. We adopted the Sepsis-3 criteria to extract the patients with sepsis and septic shock. The occurrence of transfusion during the first 3-days of intensive care unit (ICU) stay was regarded as early FFP transfusion. The primary outcome was 28-day mortality. We assessed the association of early FFP transfusion with the patient outcomes using a Cox regression analysis. Furthermore, we performed the sensitivity analysis, subset analysis, and external validation to verify the true strength of the results.Results: After adjusting for the covariates in the three models, respectively, the significantly higher risk of death in the FFP transfusion group at 28-days [e.g., Model 2: hazard ratio (HR) = 1.361, P = 0.018, 95% CI = 1.054–1.756] and 90-days (e.g., Model 2: HR = 1.368, P = 0.005, 95% CI = 1.099–1.704) remained distinct. Contrarily, the mortality increased significantly with the increase of FFP transfusion volume. The outcomes of the patients with sepsis with hypocoagulable state after early FFP transfusion were not significantly improved. Similar results can also be found in the subset analysis of the septic shock cohort. The results of external validation exhibited good consistency.Conclusions: Our study provides a new understanding of the rationale and effectiveness of FFP transfusion for the patients with sepsis. After recognizing the evidence of risk-benefit and cost-benefit, it is important to reduce the inappropriate use of FFP and avoid unnecessary adverse transfusion reactions.

Clinical application of and nursing practices for convalescent plasma transfusion in patients with COVID-19

Background: This study aimed to examine the effect of convalescent plasma transfusion on patient with severe coronavirus disease ( COVID-19 ) and discussed the main nursing practices. Methods: We retrospectively analyzed the clinical data of 21 patients with severe COVID-19 who had received convalescent plasma transfusion therapy between March 1 and April 1, 2020. The observation indicators included leukocyte, lymphocyte, C-reactive protein (CRP), interleukin-6 (IL-6), and viral antibody levels; test results from pharyngeal swabs; nucleic acid test results; chest CT results; and respiratory symptoms. Further, we summarized the nursing practices related to plasma transfusion. Results: Neither death nor transfusion-related adverse reactions were observed in patients treated with convalescent plasma transfusion. Their antibody levels, especially IgG (P < 0.05), were increased to different levels, whereas the levels of inflammatory markers (CRP), white blood cells, and lymphocytes were significantly decreased (P < 0.05). Respiratory symptoms showed an improvement, and chest CT showed stable findings. Conclusions: Convalescent plasma transfusion is safe and feasible. It can increase antibody levels, reduce inflammatory factor levels, improve white blood cell and lymphocyte counts, and improve respiratory symptoms in patients with severe COVID-19. Thus, plasma transfusion can be used as a new, effective COVID-19 treatment method that requires cooperation from nursing.

SEIR Mathematical Model of Convalescent Plasma Transfusion to Reduce COVID-19 Disease Transmission

In some diseases, due to the restrictive availability of vaccines on the market (e.g., during the early emergence of a new disease that may cause a pandemic such as COVID-19), the use of plasma transfusion is among the available options for handling such a disease. In this study, we developed an SEIR mathematical model of disease transmission dynamics, considering the use of convalescent plasma transfusion (CPT). In this model, we assumed that the effect of CPT increases patient survival or, equivalently, leads to a reduction in the length of stay during an infectious period. We attempted to answer the question of what the effects are of different rates of CPT applications in decreasing the number of infectives at the population level. Herein, we analyzed the model using standard procedures in mathematical epidemiology, i.e., finding the trivial and non-trivial equilibrium points of the system including their stability and their relation to basic and effective reproduction numbers. We showed that, in general, the effects of the application of CPT resulted in a lower peak of infection cases and other epidemiological measures. As a consequence, in the presence of CPT, lowering the height of an infective peak can be regarded as an increase in the number of remaining healthy individuals; thus, the use of CPT may decrease the burden of COVID-19 transmission.

Effect of Fresh Frozen Plasma Transfusion Inpatients with Coagulation Abnormalities

Aim: To study the efficacy of Fresh Frozen Plasma (FFP) transfusion practice in patients with coagulation abnormalities varies in clinical practice. Study Design: A retrospective study. Place and Duration of Study: This study was conducted in Department of Transfusion Medicine, SMCH, Chennai, between the period of 2019-2020. Methodology: The medical records of each patient receiving FFP transfusions that occurred in patients with coagulation abnormalities were reviewed and the data were collected based on pre-and post transfusion PT (>12 sec), APTT (>70sec) and INR (>1.5) and then analysed statistically. Patients with normal coagulation parameters were excluded from study. Results: A total of 1259 units of fresh frozen plasma were transfused to 315 patients between the year 2019-2020. Of the 1259 units transfused 1133 units where transfused to 283 patients with coagulation abnormalities. Apparently 32 patients were excluded from the study as they had normal coagulation profile. Among 251 patients, 37 patients PT were greater than 12 seconds before FFP transfusion out of which the PT was corrected for 14 patients (37.8%) after FFP transfusion. In 228 patients APTT was greater than 70 seconds before FFP transfusion, out of which APTT was corrected in 18 patients (8%) after transfusion. INR values for all 251 patients were greater than1.5 before FFP transfusion, out of which INR was corrected in 84 patients (29%) after transfusion. Conclusion: We conclude that FFP transfusions in patients with coagulation abnormalities maycorrects the defect only in less percentage of patient population, as in our study it corrects only an average of 31% of patient population.

SIR Mathematical Model of Convalescent Plasma Transfusion Applied to the COVID-19 Pandemic Data in Indonesia to Control the Spread of the Disease

In this paper we develop a mathematical model of disease transmission dynamics. Although some vaccines for some infectious diseases are available, there are some cases where handling new emerging infectious diseases, such as COVID-19 pandemic, is still a difficult problem to handle. Preventive actions, such as wearing masks, distance guarding, frequent hand washing, and others are still the most important interventions in handling the transmission of this disease. Recently, several countries have allowed the use of convalescent plasma transfusion (CPT) in the management of moderate and severe COVID-19 patients. Several early studies of this use have yielded prospective results with reduced mortality rates. A recent work also shows that using a simple discrete mathematical model of CPT could reduce the outbreak of disease transmission, in the sense of reducing the peak number of active cases and the length of the outbreak itself. In this paper, we use a continuous SIR model applied to COVID-19 pandemic data in Indonesia to address an important question whether convalescent plasma transfusion may reduce the transmission of the disease.

Asymptomatic immune thrombocytopenia in immediate post surgery following fresh frozen plasma transfusion

Occurrence of thrombocytopenia in immediate post operative period is less frequently encountered, and identifying the cause(s) is also challenging. Because multiple interventions in the form of fluid administrations, blood products transfusion, use of drugs (heparin) and increased risk of infection and organ dysfunction in post operative period can all cause thrombocytopenia. Fresh frozen plasma transfusion (FFP) transfusion is an uncommon cause of drastic thrombocytopenia, with only 14 such reported cases in the literature. And this complication is most frequently witnessed in perioperative period, 11 out of 14 of all reported cases. It is explained by transfusion of plasma containing antibodies against platelets, which develop as a consequence of plasma donors being exposed to varied platelet antigen via previous blood transfusion or during pregnancy. Here we are presenting a case of a young male who was transfused with FFP in post-operative period which led to a drastic fall in platelet count without any bleeding manifestations, which was a diagnosis of exclusion and managed with suspension of FFP transfusion.