Convalescent anti-SARS-CoV-2 plasma

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Organising pneumonia: case report A 62-year-old woman developed organising pneumonia as late manifestation of COVID-19 during treatment with convalescent anti-SARS-CoV-2 plasma for COVID-19. The woman, who had chronic lymphocytic leukaemia (CLL), type 2 diabetes and hypertension, presented with low-grade fever, shortness of breath and cough for last 1-week. She had initially received rituximab for CLL. Three months prior to the current presentation, her rituximab was switched to ibrutinib, which was discontinued due to arthralgia and palpitations [aetiology not stated] a few days before this presentation. On admission, she had hypoxia necessitating supplemental oxygen. A chest CT scan revealed bilateral ground glass opacities. A reverse transcriptase-polymerase chain reaction of nasopharyngeal swab specimen detected SARS-CoV-2 and no other respiratory viruses were found. She was enrolled in the Mayo Clinic COVID-19 expanded access program for plasma therapy on day 9 of her illness and received one dose of convalescent anti-SARS-CoV-2 plasma. Her respiratory status rapidly improved on the following day of transfusion maintaining SpO2 on room air. After 3 days, she developed low-grade fevers and increased dyspnoea necessitating supplemental oxygen. Infectious disease workup was negative. On day 17 of illness, a repeat chest CT scan findings were consistent with organising pneumonia pattern. The woman received off-label treatment with IV methylprednisolone 1 mg/kg/d resulting in resolution of fever and improved oxygenation. She was discharged in stable condition after 7 days of corticosteroids. John TM, et al. Migratory Pulmonary Infiltrates in a Patient With COVID-19 Infection and the Role of Corticosteroids. Mayo Clinic Proceedings 95: 2038-2040, No. 9, Sep 803501593 2020. Available from: URL: http://doi.org/10.1016/j.mayocp.2020.06.023

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