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Franchini M, Glingani C, Donno GD, Lucchini G, Beccaria M, Amato M, Castelli GP, Bianciardi L, Pagani M, Ghirardini M, Puma G, Presciuttini B, Costantino MT, Frigato M, Crosato V, Tiecco G, Mulè A, Papalia DA, Inglese F, Spreafico F, Garuti M, Pecoriello A, Cervi G, Greco G, Galavotti V, Santini T, Berselli A, Montalto C, Bertoletti R, Bellometti SA, Capuzzo E, Benazzi D, Grisolia G, Pajola F, Stradoni R, Zani M, Verzola A, Codeluppi V, Vesentini S, Bellocchio E, Candini M, Ambrosi G, Carandina F, Scarduelli C, Reggiani A, Casari S. Convalescent Plasma for Hospitalized COVID-19 Patients: A Single-Center Experience. Life (Basel) 2022; 12:life12030420. [PMID: 35330170 PMCID: PMC8950373 DOI: 10.3390/life12030420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80−320). Their median age was 68 years (IQR, 56−78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (<68 years), mild disease (admission to low-intensity departments) and early treatment (<7 days from symptoms onset) with high nAb titer (≥320) CCP were found as independently associated with a favorable response to CCP treatment. No safety concerns were recorded, with a rate of CCP-related adverse reactions (all of mild intensity) of 1.3%. In our real-life experience, the first in the western world, early administration of high-titer CCP was a safe and effective treatment for hospitalized COVID-19 patients.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
- Correspondence: ; Tel.: +39-0376-201234; Fax: +39-0376-220144
| | - Claudia Glingani
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Giuseppe De Donno
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Giuseppe Lucchini
- Biostatistic Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Massimiliano Beccaria
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Massimo Amato
- Emergency Department, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.A.); (D.B.)
| | - Gian Paolo Castelli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Leonardo Bianciardi
- Anesthesiology and Intensive Care Unit, SS Trinità and San Marcellino Muravera (Cagliari) Hospital, ASL 8 Cagliari, 09043 Cagliari, Italy;
| | - Mauro Pagani
- Internal Medicine Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.P.); (B.P.)
| | - Marco Ghirardini
- Department of Medicine, Hospital of Asola, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.G.); (T.S.)
| | - Giuseppe Puma
- Unit of Infectious Diseases, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.); (S.C.)
| | - Barbara Presciuttini
- Internal Medicine Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.P.); (B.P.)
| | - Maria Teresa Costantino
- Allergology and Clinical Immunology Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.T.C.); (M.F.)
| | - Marilena Frigato
- Allergology and Clinical Immunology Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.T.C.); (M.F.)
| | - Verena Crosato
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Giorgio Tiecco
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Alice Mulè
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Dorothea Angela Papalia
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Francesco Inglese
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Fabio Spreafico
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Martina Garuti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Antonietta Pecoriello
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Giulia Cervi
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Graziana Greco
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Vanni Galavotti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Tiziana Santini
- Department of Medicine, Hospital of Asola, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.G.); (T.S.)
| | - Angela Berselli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Carlo Montalto
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Riccardo Bertoletti
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Simona Aurelia Bellometti
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Enrico Capuzzo
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Dario Benazzi
- Emergency Department, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.A.); (D.B.)
| | - Gianpaolo Grisolia
- Department of Obstetrics and Gynecology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Fabio Pajola
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Raffaello Stradoni
- General Direction, Azienda Socio Sanitaria Territoriale of Valcamonica, 25043 Breno, Italy;
| | - Matteo Zani
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Adriano Verzola
- Management Planning and Control Service, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Vito Codeluppi
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Silvia Vesentini
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Elisa Bellocchio
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Marco Candini
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Giorgina Ambrosi
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Francesca Carandina
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Cleante Scarduelli
- Intensive Cardiopulmonary Rehabilitation Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Albino Reggiani
- Cardiology Unit, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Salvatore Casari
- Unit of Infectious Diseases, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.); (S.C.)
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Casari S, Lucchini G, Burato E, Bertoletti R, Boscaini R, Bellani A, Lombardi L, Benedini N, Firriolo E, Vallicella F, Ferrari G, Bellometti SA, Basili C, Stradoni R. [The COVID-19 Epidemic: the experience in the Social and Health Care Center of the Mantua District (Lombardy Region, Northern Italy)]. Epidemiol Prev 2021; 45:559-567. [PMID: 35001599 DOI: 10.19191/ep21.6.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES to describe the course of COVID-19 epidemic in the hospitals of the ASST of Mantua (Lombrady Region, Northern Italy) from February 2020 to April 2021. DESIGN observational study. SETTING AND PARTICIPANTS data from hospital discharging chart of all patients admitted to the hospitals of ASST were collected from 26.02.2020 to 30.04.2021 with COVID-19 diagnosis. Data from Emergency Rooms for patients evaluated but not admitted to departments were also collected. MAIN OUTCOME MEASURES the data from hospital discharging were crossed for diagnosis with data from laboratory. The department were classified into 'low intensity' and 'middle/high intensity'. The comparison was according to the different periods of epidemic. RESULTS patients admitted to the hospitals were 2,738: 510 died (17.3%) and 1,736 patients were evaluated in the Emergency Rooms but not admitted to departments. Among these patients, 166 died (9.6%). The prevailing age class were >=65 years, with a trend to reduction in the third wave. The proportion of admission in middle/high intensity departments was significantly higher in the second wave than in the first. N. 510 deaths by 2,738 (17.3%) were observed, with significant reduction in the second and third waves in the low intensity departments (from 21.9% to 14.3% and 12.7%) (p<0.001), while mortality was substantially unchanged in the middle/high intensity departments (28.0%, 29.6%, and 28.3%). The mortality for patients with >=65 years was 26.7%. Females showed lower mortality (OR 0.690; CI95% 0.560-0.840) and lower incidence of admissions in middle/high intensity departments (OR 0.556; CI95% 0.459-0.673) in the three waves. Finally, including also the patients not admitted, the general mortality was 15.1%. CONCLUSIONS a worse outcome by mortality and severity of disease was observed for male gender compared to female and for older age classes. Moreover, a significant improvement of outcomes in the second and third waves, compared to the first, was pointed out.
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Affiliation(s)
- Salvatore Casari
- SC malattie infettive, Azienda socio sanitaria territoriale di Mantova;
| | - Giuseppe Lucchini
- Servizio di biostatistica, Azienda socio sanitaria territoriale di Mantova
| | - Enrico Burato
- SC qualità, accreditamento e risk management, Azienda socio sanitaria territoriale di Mantova
| | | | - Renzo Boscaini
- Direzione strategica, Azienda socio sanitaria territoriale di Mantova
| | - Angela Bellani
- Dipartimento fragilità, Azienda socio sanitaria territoriale di Mantova
| | - Luisa Lombardi
- Controllo di gestione e flussi informativi, Azienda socio sanitaria territoriale di Mantova
| | - Nicola Benedini
- SC qualità, accreditamento e risk management, Azienda socio sanitaria territoriale di Mantova
| | - Elisa Firriolo
- SC qualità, accreditamento e risk management, Azienda socio sanitaria territoriale di Mantova
| | - Franco Vallicella
- Servizio infermieristico tecnico riabilitativo aziendale, Azienda socio sanitaria territoriale di Mantova
| | - Giuseppe Ferrari
- Direzione strategica, Azienda socio sanitaria territoriale di Mantova
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