Эффективность и безопасность применения плазмы реконвалесцентов у пациентов с COVID-19: систематический обзор
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Ключевые слова

COVID-19
SARS-CoV-2
плазма реконвалесцентов
антиковидная плазма

Как цитировать

Островская Е.А., Костин А.И., Буланов А.Ю. Эффективность и безопасность применения плазмы реконвалесцентов у пациентов с COVID-19: систематический обзор. Вестник интенсивной терапии имени А.И. Салтанова. 2022;(2):108–120. doi:10.21320/1818-474X-2022-2-108-120.

Статистика

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Статистика с 21.01.2023

Аннотация

АКТУАЛЬНОСТЬ. Темпы развития пандемии новой коронавирусной инфекции COronaVIrus Disease 2019 (COVID-19) и высокая летальность обусловили необходимость поиска всех возможных методов лечения. Реконвалесцентная плазма (РП) стала ценным эмпирическим ресурсом для поддержки здравоохранения, особенно на начальном этапе пандемии COVID-19. Она по-прежнему остается объектом внимания многих ученых, в то время как данные относительно эффективности РП являются достаточно противоречивыми. ЦЕЛЬ ИССЛЕДОВАНИЯ. Целью настоящего обзора является анализ результатов современных исследований по эффективности и безопасности клинического применения РП. МАТЕРИАЛЫ И МЕТОДЫ. Обзор литературы был проведен в электронных базах данных PubMed, MedRxiv, Cochrane Library, Cochrane COVID-19 study registry с 7 июня 2021 г. по 20 декабря 2021 г. РЕЗУЛЬТАТЫ. В данной работе выполнен обзор основных сравнительных ретроспективных или проспективных исследований по применению РП. Применение РП известно с 1880-х гг. при лечении дифтерии, испанского гриппа, кори, полиомиелита, а в XXI в. РП использовали при эпидемии лихорадки Эбола, вируса гриппа H1N1, других коронавирусах. Терапия РП основана на концепции пассивной иммунизации и включает в себя введение антител от доноров-реконвалесцентов, обладающих вирус-нейтрализующей активностью (ВНА) к данному вирусу. В целях минимизации рисков гемотрансмиссивных инфекций используются технологии редукции патогенов. Исторические и текущие данные об использовании РП подтверждают безопасность ее использования. Были рассмотрены критерии эффективности применения и сроки назначения РП. Представлены клинические данные, подтверждающие эффективность РП у определенных групп пациентов. ВЫВОДЫ. Применение РП является безопасным и целесообразно у серонегативных больных с COVID-19 на ранних сроках заболевания или при наличии иммунодефицитного состояния. Наибольшей эффективностью обладает РП с высокими титрами ВНА. У тяжелых больных на поздних сроках болезни терапия РП не приводит к регрессии заболевания и увеличению выживаемости.

https://doi.org/10.21320/1818-474X-2022-2-108-120
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