COVID-19 Disease has strained our healthcare system. Convalescent plasma has been used to treat emerging infectious diseases - Influenza A/B, SARS-CoV, Ebola virus and now SARS-CoV 2. OBJECTIVE: This study aims to determine the outcome and clinical course of COVID-19 patients who received convalescent plasma transfusion at Cardinal Santos Medical Center. METHODS: This is a retrospective cohort analytical study of 75 patients who received convalescent plasma. RESULTS: Median time from admission to CP transfusion was 3 days. Majority of patients received additional therapies including dexamethasone (100%); Remdesivir (95%); antibiotics (100%), tocilizumab (65%); hemoperfusion (88%) or combination of these. Among the survivors, the median LOS was 15 days while non-survivors have a median LOS of 6 days. One patient (1.33%) had mild transfusion reaction. Four patients (5.33%) developed DVT despite anti-coagulation. There was improvement in the inflammatory markers (LDH pvalue 0.04, CRP pvalue 0.00, Ferritin pvalue 0.0001). There was improvement in the pulmonary parameters - increase in mean PaO2, mean SaO2, and mean PFR; and decrease in mean FiO2 and mean RR post-treatment. Median LOS is 14 days for the CP group vs 11 days for the non-CP group. Mortality rate among the CP group is 25.33% while the non-CP group was 26.67%. LOS and mortality rate did not reach statistical significance. CONCLUSIONS: There was no significant difference in mortality and length of hospital stay in patients given CP vs controls. CP might have a role in the improvement of inflammatory markers and pulmonary status.
The COVID-19 disease caused by SARS-CoV2 virus has gripped the whole world with overwhelming strain in our health system. Currently, there are no standard guidelines in its treatment but the possible benefits of convalescent plasma in limiting complications and severity of the COVID-19 disease have emerged. OBJECTIVE: This study aims to determine the effectiveness and safety of using convalescent plasma in improving the clinical course of hospitalized patients diagnosed with COVID-19 disease admitted at University of Santo Tomas and Makati Medical Center. METHODS: This study is a quasi-experimental (prospective analytical), and multi-center study involving 65 patients diagnosed with COVID-19 Disease who received convalescent plasma, with 65 patients who only received best available treatment serving as age-gender-matched control. RESULTS: Median age of the population who received convalescent plasma was 60 years old, mostly male (68%), and manifested severe pneumonia (47%). There was noted statistically signifcant decrease between the pre-and post-treatment values of hemoglobin (p=0.04) and LDH (p=0.086). There was also statistically significant increase in platelet counts (p=0.01). WBC and PaO2 increased while ferritin and PFR decreased after convalescent plasma transfusion, however, these were not statistically significant. Length of stay and clinical outcome of those who received convalescent plasma were then compared to age-gender matched controls who only received best available treatment. There was noted statistically significant difference between length of stay (p=0.00) among those who received convalescent plasma as compared to those who did not. This was seen across severe and critically ill COVID-19 patients. There was also more mortality seen in the best available treatment alone group, but this was non-significant. CONCLUSIONS: Convalescent plasma use showed no significant impact in the recovery rate and outcome of patients who received it as compared to those who did not, however, its use was proven to be safe among all patients regardless of the level of severity and clinical profile.
Introduction Multiple myeloma (MM) causes generalized bone loss leading to lytic bone lesions and pathologic fractures. The increased osteoclast activity and reduced osteoblast function favors bone resorption and decreased bone formation. Vitamin D is vital in regulating calcium homeostasis and osteoclast-mediated bone resorption. Defi ciency of Vitamin D among MM patients may complicate bone mineralization problems and fractures. Objective General Objective To determine the status of Vitamin D in patients with multiple myeloma Specifi c Objective To determine the levels of Vitamin D, intact parathyroid hormone and ionized calcium among MM patients Methodology This is a prospective, cross-sectional study which included patients who were 18 years old and above, male or female, diagnosed with MM at the University of Santo Tomas Hospital, with or without treatment. Excluded in the study were those with Vitamin D and calcium supplementation. Eligible subjects were extracted blood for Vitamin D assay, intact parathyroid hormone and ionized calcium. Results A total of 22 patients with MM were included in the study. Sixteen patients (72.7%) had hypovitaminosis D. Among these sixteen patients, seven (31.8%) had Vitamin D defi ciency (Vitamin D levels <20 ng/mL [50 nmol/L]) and nine (40.9%) had Vitamin D insuffi ciency (levels of 21-29 ng/ mL [52.5-72.5 nmol/L]). Only 6 (27.3%) of them were found to have normal serum Vitamin D (levels of >29 ng/mL [>72.5 nmol/L]). The mean age (p=0.069), intact PTH (p=0.062) and ionized calcium (p=0.188) of the three groups of patients did not differ. Conclusion This study found a high incidence of Vitamin D defi ciency among MM patients seen at the University of Santo Tomas Hospital. Vitamin D defi ciency was independent of age, intact PTH and ionized calcium. It was more common in male subjects. Patients with hypovitaminosis D are at risk of having secondary hyperparathyroidism. Recommendation Vitamin D status should be determined among patients with MM. Early recognition and treatment of hypovitaminosis D will prevent the risk of having secondary hyperparathyroidism that can complicate skeletal-related events.
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