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Author: Chen Qianting
2020-10-27 00:00
Last update date: 2020-10-27 00:00
So far, more than 5,000 people in Hong Kong have been infected with the new type of coronavirus pneumonia. Many of them are seriously ill and some have even died.
According to the current situation, if the antiviral drugs are not effective, the patient will be injected into the recovered plasma donated by the recovered patient to effectively remove the virus from the body and relieve inflammation.
Kong Fanyi, an honorary consultant doctor of the Department of Internal Medicine at Queen Mary Hospital and clinical professor of the Department of Internal Medicine at the University of Hong Kong School of Medicine, revealed that so far, about 50 patients in Hong Kong have received plasma recovery therapy, all without side effects. Among them, 30 and 6 adults have recovered and 11 have passed away. The mortality rate is about 22%. Most of them are elderly people or people with long-term illnesses.
He revealed that the current recovery of plasma stock in Hong Kong can supply about 40 patients, but type A and type B plasma are in short supply. It is expected that the plasma stock can be increased to 60 to 70 packs to help cope with the fourth wave of the epidemic.
The recovered plasma donated by survivors of new pneumonia patients can help critically ill patients clear the virus and reduce inflammation.
(Photo provided by Queen Mary Hospital)
Among the more than 5,000 new pneumonia patients in Hong Kong, more than 100 died after being infected. Some patients are seriously or even critically ill. Antiviral drug treatment may not be effective. At that time, recovery of plasma therapy for recovered patients may be helpful.
A 60-year-old female patient with antiviral drugs ineffective can be discharged after three weeks of plasma transfusion twice
Hong Fanyi, a clinical professor in the Department of Internal Medicine at the Faculty of Medicine of the University of Hong Kong, mentioned that one of the 67-year-old female patients who was seriously ill, had a lymphoma, and contracted the new type of coronavirus pneumonia one year after recovery. The antiviral drugs protease inhibitor and ribavirin were prescribed, but the response was normal. After that, he took the "magic drug" Redcivir for 10 days, but still did not improve, so the patient was given two recovery plasma.
After the patient used plasma for the first time, within three days, the amount of virus dropped from 1 billion virus per ml sample to about 1 million to 10 million virus per ml. The pneumonia condition improved, and within one week after the second plasma transfusion The virus test has turned negative and the condition improved quickly. There is no need to intubate the throat. The degree of pulmonary fibrosis is also "good enough". It is now more feasible to go up to two stairs. The patient is only discharged from the plasma Things in the three-star period.
Plasma can regulate the immune system
Kong Fanyi explained that plasma therapy is suitable for patients who are seriously ill, require ventilator and oxygen supply, and have severe lung failure who need to be transferred to the intensive care unit. Most of these patients are elderly and have long-term illnesses with poorer immune systems than ordinary people. Autoimmunity produces antibodies, so plasma is needed to regulate the immune system, remove viruses from the body, reduce inflammation and cytokine storms, and help reduce mortality and improve cure rates.
Kong Fanyi pointed out that restoring plasma helps to clear the virus from the patient's body and reduce inflammation and cytokine storms, helping to reduce mortality and increase the cure rate.
(Photo by Liang Pengwei)
Or let the patient use recovery plasma treatment early
Since the outbreak of the new type of pneumonia, a total of about 50 severely ill patients in Hong Kong have received plasma resumption therapy, and no one has experienced side effects.
Thirty people have recovered, 17 of them have been discharged from the hospital, 13 are in stable condition, 9 are currently in serious condition, and the remaining 11 have passed away. The death rate is about 22%.
Kong Fanyi pointed out that most of the deceased were elders over the age of 75, who had long-term illnesses themselves, and even with plasma treatment, they might be lost within a few days.
The doctor will first prescribe three antiviral drugs for the patient. If it does not work after 5 days, he will prescribe a small dose of steroids. If there is no improvement and the patient has respiratory failure, he will consider using recovery plasma. The patient will generally be after the onset of the disease. On the 10th to 14th day, he received plasma transfusion. Kong Fanyi said that if the stock is sufficient in the future, he may consider using the recovery plasma earlier than the 8th day.
At present, there are about 50 patients who have recovered from the new type of pneumonia in Hong Kong who are eligible and donated recovery plasma.
(Photo provided by Queen Mary Hospital)
The antibody level will drop to the original 4 points after three months.1
Recovered patients with new type of pneumonia must meet a number of conditions to become reinstated plasma donors. Kong Fanyi pointed out that eligible patients will be referred to Queen Mary Hospital for follow-up consultation. Only 10% of the 400 to 500 follow-up patients are suitable Donations, the median age is 45 years.
As for whether the plasma can be donated more than once, it depends on the level of neutralizing antibody of the patient. In patients with more severe inflammation, the level of antibody will be higher, reaching a level of 1:320 or even 1:640. He has donated 5 times of recovery plasma, and 3 people have donated 3 times. However, since the patient's antibody level generally drops to one-fourth of the original within three to six months after recovery, many recovered patients can only donate once plasma.
Conditions for donating plasma:
Males 18-60 years old
Weigh more than 50 kg
No chronic disease
Neutralizing antibody level is 1:80 or above
No new coronavirus in the body
Have recovered for two weeks
He also reminded that in many places, including Hong Kong, patients were re-infected after recovery, which means that recovery is not equivalent to lifelong immunity. Therefore, before the vaccine is successfully developed, epidemic prevention measures are very important. He also pointed out that there is reason to believe that there will be new pneumonia in the future. The vaccine will be the same as the flu vaccine and will need to be vaccinated once a year to provide adequate protection.
Hope to store 60 to 70 packets to restore plasma to treat severe patients
At present, the restored plasma stock in Hong Kong can be used by more than 40 severe patients. The blood types A and B are relatively lacking. Patients can donate 500ml each time. If there are enough antibodies, plasma can be donated every two weeks. The plasma can be stored. One year.
Kong Fanyi pointed out that there are now more stocks than at the beginning of the third wave of the epidemic. At that time, there were only enough for more than ten people to use. However, he hopes that the stock can be increased to 60 to 70 packs of plasma to deal with the fourth wave of epidemic.
▼Reopening of premises and relaxation measures starting on October 23▼
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