Abstract：
Donor-recipient proximity emerged as an important factor influencing the efficacy of COVID-19 convalescent plasma (CCP) treatment during the early stages of the COVID-19 pandemic. This relationship was uncovered while analyzing data collected in the collaborative Expanded Access Program (EAP) for CCP at Mayo Clinic, a project aimed to establish protocols for CCP use amid the uncertainty of the novel disease. Analysis of data from nearly 28,000 patients revealed a significant reduction in risk of 30-day mortality for those receiving near-sourced plasma when compared to those receiving distantly sourced plasma [pooled relative risk, 0.73 (95% CI 0.67-0.80)], prompting adjustments in treatment protocols at selected institutions, and highlighting the importance of proximity in optimizing CCP outcomes. Despite its significance, subsequent studies of CCP effectiveness in COVID-19 have often overlooked donor-recipient proximity. Our findings emphasize the importance of donor-recipient proximity in CCP treatment in the current pandemic, and we discuss potential methods for improving CCP efficacy in future pandemics. Our recommendations include prioritizing virus genotyping for vulnerable patients, establishing a robust testing infrastructure, and collecting additional donor data to enhance plasma selection. This chapter underscores the importance of comprehensive data collection and sharing to navigate the evolving landscape of newly emerging infectious diseases.
摘要：
在COVID-19大流行的早期阶段，供体与受体的接近成为影响COVID-19恢复期血浆（CCP）治疗疗效的重要因素。在分析梅奥诊所的CCP协作扩展访问计划（EAP）中收集的数据时，发现了这种关系，一个项目旨在建立在新疾病不确定的情况下使用CCP的协议。对近28,000名患者的数据进行的分析显示，与接受远源血浆的患者相比，接受近源血浆的患者30天死亡率的风险显着降低[汇总相对风险，0.73（95%CI0.67-0.80）]，促使选定机构调整治疗方案，并强调接近在优化CCP结果中的重要性。尽管意义重大,随后关于CCP在COVID-19中的有效性的研究经常忽略了供体与受体的亲近感。我们的研究结果强调了在当前大流行中，在CCP治疗中，捐赠者与接受者之间的亲密关系的重要性，我们讨论了在未来大流行中提高CCP疗效的潜在方法。我们的建议包括优先为弱势患者进行病毒基因分型，建立强大的测试基础设施，并收集额外的供体数据以增强血浆选择。本章强调了全面数据收集和共享的重要性，以应对新出现的传染病的不断变化。
