首页|COVID-19合并肝功能不全患者输注SARS-CoV-2抗体阳性血浆诱导抗体依赖性增强效应的效果分析

COVID-19合并肝功能不全患者输注SARS-CoV-2抗体阳性血浆诱导抗体依赖性增强效应的效果分析

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目的 探讨合并肝功能不全的COVID-19患者输注SARS-CoV-2抗体阳性库存血浆是否诱导抗体依赖性增强(ADE)效应。方法 回顾性分析该院2022年12月15日至2023年1月20日收治的26例输注含SARS-CoV-2多克隆抗体库存血浆的COVID-19合并肝功能不全患者的临床资料,比较分析患者输注血浆前后外周血单核细胞(MONO)计数、白细胞介素(IL)-2、IL-4、IL-6、IL-10、肿瘤坏死因子(TNF)-α、γ-干扰素(IFN-γ)等细胞因子水平变化。以同期37例未输注血浆的患者为对照组,比较两组患者治疗第5天外周血MONO计数、细胞因子水平、咽拭子SARS-CoV-2核酸检测、肺部感染病灶吸收等情况。结果 观察组与对照组治疗第5天外周血MONO计数升高者比例(69。23%vs。59。56%)、细胞因子升高者比例(IL-2:66。67%vs。76。92%、IL-4:22。22%vs。46。15%、IL-6:33。33%vs。38。46%、IL-10:33。33%vs。30。27%、TNF-α:33。33%vs。46。15%、IFN-γ:44。44%vs。61。54%)、咽拭子 SARS-CoV-2 核酸检 测阴性 者比例(46。67%vs。59。09%)、病灶开始吸收者比例(87。50%vs。84。85%)比较,差异均无统计学意义(P>0。05)。结论 COV-ID-19 合并肝功能不全患者输注含SARS-CoV-2多克隆抗体的库存血浆未诱导明显的ADE效应。
Effect analysis of antibody dependent enhancement effect induced by anti-SARS-CoV-2 antibody positive plasma infusion in patients with COVID-19 complicating liver dysfunction
Objective To investigate whether or not the infusion of anti-SARS-CoV-2 antibody-positive stock plasma inducing the antibody-dependent enhancement(ADE)effect in the patients with COVID-19 complicating liver dysfunction.Methods The clinical data of 26 patients with COVID-19 complicating liver dysfunction infused with SARS-CoV-2 antibody-positive stock plasma in this hospital from December 15,2022 to January 20,2023 were analyzed retrospectively.The changes of peripheral blood mononuclear cells(MONO)count and cytokines IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ levels were compared and analyzed before and after plasma infusion.Thirty-seven patients with COVID-19 without plasma infusion during the same period served as the control group.The situation such as peripheral blood MONO count,cytokines lev-els,throat swab SARS-CoV-2 nucleic acid test,pulmonary infection lesion absorption on 5 d of treatment were compared between the two groups.Results The proportions of peripheral blood MONO count increase in the observation group and control group were 69.23%and 59.56%respectively,the proportions of cytokines in-crease were 66.67%vs.76.92%for IL-2,22.22%vs.46.15%for IL-4,33.33%vs.38.46%for IL-6,33.33%vs.30.27%for IL-10,33.33%vs.46.15%for TNF-α and 44.44%vs.61.54%for IFN-γ,the throat swab SARS-CoV-2 nucleic acid detection negative ratio was 46.67%vs.59.09%.The proportion of the pa-tients with lesion absorption beginning was 87.50%vs.84.85%,and the differences were not statistically sig-nificant(P>0.05).Conclusion Infusion of stock plasma containing anti-SARS-CoV-2 polyclonal antibodies in the patients with COVID-19 complicating liver dysfunction does not induce significant ADE.

COVID-19SARS-CoV-2polyclonal antibodystock plasmaantibody dependent enhancement

雷震、斯志娟、宗亚力、王淑梅

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南昌市中心医院(南昌市第九医院、南昌大学附属感染病医院)输血科,南昌 330002

南昌市中心医院(南昌市第九医院、南昌大学附属感染病医院)检验科,南昌 330002

南昌市中心医院(南昌市第九医院、南昌大学附属感染病医院)中西结合科,南昌 330002

南昌市中心医院(南昌市第九医院、南昌大学附属感染病医院)呼吸科,南昌 330002

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新型冠状病毒感染 严重急性呼吸综合征冠状病毒2 多克隆抗体 库存血浆 抗体依赖性增强

江西省重点项目(定向委托)

2020YBBGWL004

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(19)
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