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Convalescent plasma therapy in obese severe COVID-19 adolescents: Two cases report
Citra Cesilia1, Elmi Ridar2, Nur Suryawan2
1Department of Child Health, Faculty of Medicine, Riau University - Arifin Achmad General Hospital, Pekanbaru, Indonesia.
Insights
Convalescent Plasma Therapy (CPT) showed promise in treating severe COVID-19 in Indonesian children, with two obese patients experiencing improved symptoms. Further research is needed to establish CPT
Area of Science:
- Pediatric Infectious Diseases
- Critical Care Medicine
- Hematology/Transfusion Medicine
Background:
- High pediatric mortality from COVID-19 in Indonesia (175 deaths, March-December 2020).
- Limited studies on Convalescent Plasma Therapy (CPT) safety and efficacy in pediatric populations.
- This case report is the first to document CPT in Indonesian children.
Observation:
- Two obese pediatric patients presented with severe COVID-19 symptoms: progressive shortness of breath, worsening cough, and high fever.
- Both patients met the criteria for severe COVID-19.
- Convalescent Plasma Therapy (CPT) was administered to these patients.
Findings:
- CPT administration led to significant clinical improvement in both pediatric patients.
- Patients were discharged in improved condition following CPT.
- Key factors influencing CPT efficacy include donor antibody titer, treatment timing, and patient comorbidities.
- Combination therapy of CPT and remdesivir demonstrated improved clinical impact.
Implications:
- CPT appears well-tolerated in adolescents with severe COVID-19, with no reported adverse events.
- CPT shows potential for improving clinical outcomes in pediatric severe COVID-19 cases.
- Further robust studies with stronger evidence are warranted to explore CPT's role in pediatric COVID-19 management.
Background:
In Indonesia, 175 cases resulted in death in children from March to December 2020. Studies regarding Convalescent Plasma Therapy's (CPT) safety and efficacy in children are scarce. Our case report was the first to write CPT in Indonesian children.
Case Presentation:
In our case, two obese children with progressive shortness of breath, worsening cough, and high fever, the findings met severe COVID-19 criteria. We performed CPT for these patients and the patient's condition was improved and able to be discharged.
Discussion:
Severe COVID-19 with or without comorbid was the indication of CPT which had been approved by the U.S. FDA and Indonesian Pediatrics Society. The key factors associated with CPT efficacy were the donor's titer antibody, the treatment time point, and the patient's comorbidities. The clinical impact showed an improvement by the combination therapy of CPT and remdesivir.
Conclusion:
We noted that CPT might be well tolerated, could improve the clinical impact of severe COVID-19 in adolescents, and have no adverse events as well. CPT for severe COVID-19 cases in children had the potential to be developed in studies with better designs and stronger levels of evidence.
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