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CONVALESCENT PLASMA AS A THERAPEUTIC MODALITY IN HEMATOLOGICAL PATIENTS WITH COVID19 PNEUMONIA - A REVIEW OF THE RESULTS OF PATIENTS TREATED IN UNIVERSITY HOSPITAL DUBRAVA

During the COVID19 pandemic, University Hospital Dubrava treated, among others, hematological patients with COVID19 disease. Large proportion of hematological patients have overt secondary immunodeficiency mainly due to treatments that also target cells that are the base of humoral and cellular response. In COVID-19 it is manifested by diminished specific immunological response and prolonged disease course. Passive immunization with convalescent plasma in these setting may be helpful. Total of 40 patients (24 men, 16 women) received convalescent plasma (rFFP) as part of treatment. The mean age at hospitalization was 65 years (age range 28–88 years). The median time from the onset of symptoms or the first positive test to hospitalization is 11.5 days. The most common hematological disease was chronic lymphocytic leukemia (13 patients, 32.5%), followed by follicular lymphoma (5), mantle cell lymphoma (3), multiple myeloma (3), and acute myeloid leukemia (2). Thirty patients (75%) had a history of treatment for the underlying hematological disease, and 22 patients were currently being treated, of whom 11 were receiving rituximab. All patients were admitted for bilateral pneumonia. On admission, IgG antibodies to SARS-CoV-2 were tested in 34 patients, of whom only two had a positive result. Positive serum PCR SARS-CoV-2 was found in 15 patients (37.5%). The median number of rFFPs administered is 4 (range 1 -15), mostly 18.5 days after the onset of symptoms, or on day 4 of hospitalization. The majority of patients (30, 75%) were treated with oxygen therapy at the first dose of rFFP ; 7 patients were treated with high-flow oxygen therapy and two were mechanically ventilated. 16 patients (40%) died, and hospitalization lasted an average of 26 days. In conclusion, passive immunization with rFFP may help control COVID-19 infection until patient's own immunological system recovers from consequences of previous immunosuppressive treatments.

passive antibody therapy ; convalescent plasma ; COVID-19 ; SARS-CoV-2 ; wild-type virus neutralization assay

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