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Non-optimal effectiveness of convalescent plasma transfusion and hydroxychloroquine in treating COVID-19: a case report.

恢复期血浆输注与羟氯喹治疗新型冠状病毒肺炎疗效不佳 1 例。

  • 影响因子:2.48
  • DOI:10.1186/s12985-020-01354-6
  • 作者列表:"Xu TM","Lin B","Chen C","Liu LG","Xue Y
  • 发表时间:2020-06-19
Abstract

BACKGROUND:Convalescent plasma (CP) transfusion was reported to be effective in treating critically ill patients with COVID-19, and hydroxychloroquine could potently inhibit SARS-CoV-2 in vitro. Herein, we reported a case receiving combination therapy with CP transfusion and hydroxychloroquine for the first time. CASE PRESENTATION:Laboratory findings showed high lactic acid level (2.1 mmol/L) and C-reactive protein (CRP, 48.8 mg/L), and low white blood cell count (1.96 × 109/L) in a 65-year-old Chinese man, who was diagnosed with severe COVID-19. CP was intravenously given twice, and hydroxychloroquine was orally administrated for a week (0.2 g, three times a day). The lactic acid and C-reactive protein levels remained high (2.1 mmol/L and 73.23 mg/L, respectively), while the arterial oxyhemoglobin saturation decreased to 86% with a low oxygenation index (OI, 76 mmHg) on day 4 after CP transfusion. His temperature returned to normal and the OI ascended above 300 on day 11. Moreover, the RNA test remained positive in throat swab, and computed tomography revealed severe pulmonary lesions on day 11 after admission. CONCLUSION:These findings suggested that the effectiveness of combination therapy with CP and hydroxychloroquine may be non-optimal, and specific therapy needs to be explored.

摘要

背景: 恢复期血浆输注治疗危重症新型冠状病毒肺炎疗效显著,羟氯喹在体外能有效抑制SARS-CoV-2。在此,我们报告了一例首次接受CP输血和羟氯喹联合治疗的病例。 病例报告: 实验室检查结果显示高乳酸水平 (2.1 mmol/L) 和C反应蛋白 (CRP,48.8 mg/L),和低白细胞计数 (1.96 × 109/L) 在一个 65 岁的中国男子,谁被诊断为严重的新型冠状病毒肺炎。CP静脉滴注 2 次,羟氯喹口服 1 周 (0.2g,每日 3 次)。乳酸和C反应蛋白水平仍然很高 (分别为 2.1 mmol/L和 73.23 mg/L),而动脉氧合血红蛋白饱和度在CP输血后 86% 天下降至,氧合指数低 (OI,76 mmhg)。他的体温恢复正常,11 天OI上升到 300 以上。此外,咽拭子RNA检测仍呈阳性,入院后第 11 天计算机断层扫描显示严重肺部病变。 结论: CP与羟氯喹联合治疗可能疗效不佳,具体治疗方法有待探讨。

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呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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