BACKGROUNDPassive immunotherapy with convalescent plasma (CP) is a potential treatment for COVID-19. Evidence from controlled clinical trials is inconclusive.METHODSWe conducted a randomized, ...open-label, controlled clinical trial at 27 hospitals in Spain. Patients had to be admitted for COVID-19 pneumonia within 7 days from symptom onset and not on mechanical ventilation or high-flow oxygen devices. Patients were randomized 1:1 to treatment with CP in addition to standard of care (SOC) or to the control arm receiving only SOC. The primary endpoint was the proportion of patients in categories 5 (noninvasive ventilation or high-flow oxygen), 6 (invasive mechanical ventilation or extracorporeal membrane oxygenation ECMO), or 7 (death) at 14 days. Primary analysis was performed in the intention-to-treat population.RESULTSBetween April 4, 2020, and February 5, 2021, 350 patients were randomly assigned to either CP (n = 179) or SOC (n = 171). At 14 days, proportion of patients in categories 5, 6, or 7 was 11.7% in the CP group versus 16.4% in the control group (P = 0.205). The difference was greater at 28 days, with 8.4% of patients in categories 5-7 in the CP group versus 17.0% in the control group (P = 0.021). The difference in overall survival did not reach statistical significance (HR 0.46, 95% CI 0.19-1.14, log-rank P = 0.087).CONCLUSIONCP showed a significant benefit in preventing progression to noninvasive ventilation or high-flow oxygen, invasive mechanical ventilation or ECMO, or death at 28 days. The effect on the predefined primary endpoint at 14 days and the effect on overall survival were not statistically significant.TRIAL REGISTRATIONClinicaltrials.gov, NCT04345523.FUNDINGGovernment of Spain, Instituto de Salud Carlos III.
Therapeutic strategy in the transplanted patient Núñez-Orantos, M J; Julián-Jiménez, A; Candel, F J ...
Revista española de quimioterapia,
11/2023, Letnik:
36 Suppl 1, Številka:
Suppl1
Journal Article
Odprti dostop
The SARS-CoV-2 infection prognosis has dramatically changed as a result of population vaccination and the surge of omicron. However, there are still specific populations at risk of progression to ...severe diseases that require hospitalization or even at risk of death. The kidney transplant population is one of them. Consequently, when compatible symptoms appear, an early diagnosis should be sought in order to start specific antiviral treatment as soon as possible to avoid clinical deterioration of the patient. Antivirals have shown, in transplant patients, a decrease in the rate of hospitalization and death, especially with their early administration.
Highlights from 22nd International AIDS Conference Núñez-Orantos, M J; Cabello Clotet, N; Vergas García, J ...
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia,
09/2019, Letnik:
32 Suppl 2, Številka:
Suppl 2
Journal Article, Conference Proceeding
Practical Decalogue in the management of sepsis González Del Castillo, J; Núñez Orantos, M J; Candel, F J ...
Revista española de quimioterapia
31 Suppl 1, Številka:
Suppl 1
Journal Article
Odprti dostop
Sepsis is a complex entity where there are still many controversies regarding diagnosis and therapeutic management. The present article pretends to review the recently published in relation to these ...disagreements and contains a proposal of practical approach to the infected patient.
To develop a set of recommendations, by consensus of Emergency Medicine experts, on key aspects related to the care of adult patients with acute infection attended in Spanish emergency departments ...(ED).
The study was divided into three phases: 1) To design a questionnaire by a coordinating group; 2) To conduct a survey in ED physicians in order to know their opinion on the issues raised by the coordinating group; 3) To develop a number of recommendations based on the responses to the questionnaire and their subsequent discussion.
A group of 28 experts from different Spanish ED, as well as 5 members of the coordinating group, with knowledge and experience in the management of infectious diseases in ED, conducted a round of voting to a questionnaire of 18 issues grouped into three sections: 1) identification and stratification of the severity; 2) diagnosis and treatment; 3) management.
A monitoring system and proper training of the entire healthcare team are required, as well as extensive knowledge on these issues, to ensure adequate and effective care for these patients. It is essential to educate and train all health staff, especially in the ED, because it is the initial point of contact for most patients with an infection. The experts established proposals based on survey questions and the discussion.
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