Nayi idili ngokunikela nge-Plasma Convalescent yeziguli ze-COVID-19

-Delile

• Ngakho-ke, Luyini Ukwelashwa Kwe-Plasma Convalescent, Ngokuqondile?
• Ubani Onganikela Nge-Plasma Ye-Convalescent ye-COVID-19?
• Uhlanganisani Umnikelo We-Plasma We-Convalescent?
• Buyekeza kwe-

Kusukela ngasekupheleni kukaMashi, ubhadane lwe-coronavirus luqhubekile nokufundisa isizwe - kanye nomhlaba - wonke amagama amaningi: ukuqhela kwezenhlalo, okokuvikela (PPE), ukulandelela oxhumana nabo, ukubala nje abambalwa. Kubonakala sengathi usuku ngalunye oludlulayo (olubonakala luhlala njalo) kunentuthuko entsha eletha ibinzana eliyiqiniso elizokwengezwa kusichazamazwi esikhula njalo se-COVID-19. Enye yezengezo zakamuva ezwini lakho elinothe kakhulu? Ukwelashwa kwe-plasma ye-Convalescent.

Akujwayelekile? Ngizochaza…

Ngo-Agasti 23, 2020 i-US Food and Drug Administration (i-FDA) yagunyaza ukusetshenziswa okuphuthumayo kwe-plasma yokululama - ingxenye yegazi ecebile ngamasosha omzimba ethathwe ezigulini ezitholakele ze-COVID-19 - ekwelapheni amacala anzima we-coronavirus. Kwathi kungakapheli ngisho isonto, ngoSepthemba 1, i-COVID-19 Panel Guidelines Panel, eyingxenye yeNational Institutes of Health (NIH), yajoyina ingxoxo, yathi kukhona "idatha enganele yokuncoma noma ukusetshenziswa yeplasma elulamayo elashwa i-COVID-19. ”

Ngaphambi kwalo mdlalo, i-convalescent plasma yanikezwa iziguli ezigulayo ze-COVID-19 ngohlelo oluholwa yiMayo Clinic-Expanded Access Programme (EAP), olwaludinga ukubhaliswa kodokotela ukuze kucele i-plasma yeziguli, ngokusho kwe-FDA. Manje, ukuya phambili, i-EAP isiphelile futhi ithathelwa indawo yi-FDA's Emergency Use Authorization (EUA), evumela odokotela nezibhedlela ukuthi bacele i-plasma ngaphandle kokuhlangabezana nenqubo ethile yokubhalisa. Kepha, njengoba kugcizelelwe isitatimende sakamuva se-NIH, ucwaningo olwengeziwe luyadingeka ngaphambi kokuba noma ngubani akwazi ngokusemthethweni (futhi ngokuphephile) atuse ukwelashwa kwe-plasma ye-convalescent njengendlela yokwelapha ethenjwayo ye-COVID-19.

Ukwelashwa kwe-plasma ye-Convalescent kufinyeleleka kakhulu kunangaphambili njengokwelashwa okungenzeka kwe-COVID-19 e-US, kodwa kuyini ngempela? Futhi unganikela kanjani nge-plasma yokululama yeziguli ze-COVID-19? Ngaphambili, konke odinga ukukwazi.

Ngakho-ke, Luyini Ukwelashwa Kwe-Plasma Convalescent, Ngokuqondile?

Okokuqala, iyini i-plasma yokululama? IConvalescent (isichasiso kanye nesabizo) kubhekise kunoma ngubani olulama esifweni, kanti i-plasma yingxenye yegazi ephuzi, ewuketshezi equkethe amasosha omzimba wesifo, ngokusho kwe-FDA. Futhi, uma kwenzeka uphuthe ekilasini le-biology yebanga lesi-7, amasosha omzimba angamaprotheni akhelwa ukulwa nezifo ezithile ngemva kokuba nalolo kutheleleka.

Ngakho-ke, i-convalescent plasma imane nje iyiplasma yomuntu oseluleme esifweni - kulokhu, i-COVID-19, kusho uBrenda Grossman, MD, umqondisi wezokwelapha we-Transfusion Medicine esibhedlela i-Barnes-Jewish, kanye noprofesa eWashington University School of Imithi e-St. "Ama-plasmas we-Convalescent asetshenziswe esikhathini esidlule, ngamazinga ahlukene okusebenza, ezifweni ezithathelwanayo eziningana, kufaka phakathi i-Spanish Flu, i-SARS, i-MERS ne-Ebola," kusho uDkt Grossman.

Manje-ke lapho “ukwelashwa” kungena khona: Lapho nje i-plasma itholakele kumuntu oseluleme, ifakwa esigulini esikhona (futhi kaningi kakhulu) esigulayo ukuze amasosha omzimba abe nethemba lokuthi “angalinciphisi igciwane futhi aqinise nokususwa kwegciwane emzimbeni,” kusho u-Emily Stoneman, MD, uchwepheshe wezifo ezithathelwanayo eNyuvesi yaseMichigan e-Ann Arbor. Ngamanye amagama, isetshenziselwa "ukukhulisa ukuzivikela kwesiguli futhi ngethemba lokuthi kunciphisa umthelela wokugula."

Kodwa, njengokuningi empilweni (ugh, ukuphola ), isikhathi siyikho konke. UDkt. Stoneman uyachaza: “Ngokuvamile kuthatha cishe amasonto amabili ukuthi abantu abangenwe yi-COVID-19 bazikhiqizele la magciwane. iziguli zingaguli kakhulu, ”Ngakho-ke, ngenkathi kusadingeka ucwaningo oluthe xaxa ukuthola ukuthi iyasebenza yini indlela yokwelashwa kwe-plasma yokululama, umqondo wamanje uthi lapho isiguli sithola ukwelashwa ngaphambi kwesikhathi, maningi amathuba okuthi zithole imiphumela emihle. (Okuhlobene: Ungabhekana Kanjani Nokukhathazeka Kwezempilo Ngesikhathi Se-COVID-19, Nangaphezulu)

Ubani Onganikela Nge-Plasma Ye-Convalescent ye-COVID-19?

Inombolo yokuqala yokufaneleka: ubune-coronavirus futhi unesivivinyo sokukufakazela.

"Abantu banganikela nge-plasma uma benokutheleleka nge-COVID-19 ngemibhalo elabhorethri (kungaba i-nasopharyngeal [nasal] swab noma i-positive antibody test), sebeluleme ngokuphelele, futhi abanazimpawu zokungenani okungenani amasonto amabili," kusho uHyunah Yoon, MD, uchwepheshe wezifo ezithathelwanayo e-Albert Einstein College of Medicine. (Funda futhi: Ngabe Kusho Ukuthini Ukuhlolwa Kokulwa Nomzimba Okushiwo Ngempela?)

Awunakho ukuxilongwa okuqinisekisiwe kodwa uqiniseka ukuthi uhlangabezane nezimpawu ze-coronavirus? Izindaba ezinhle: Ungahlela ukuhlolwa kwe-antibody e-American Red Cross yangakini futhi, uma imiphumela ilungile kuma-antibodies, qhubeka ngokufanele - lokho-ke, inqobo nje uma uhlangabezana nezinye izidingo zabanikeli, njengokungenazimpawu okungenani izinsuku eziyi-14 ngaphambi komnikelo. Ngenkathi amasonto amabili ngaphandle kwezimpawu kunconywa yi-FDA, ezinye izibhedlela nezinhlangano zingadinga ukuthi abanikeli bangabi nazimpawu izinsuku ezingama-28, kusho uDkt. Grossman.

Ngaphandle kwalokho, i-American Red Cross idinga ukuthi abanikeli be-plasma ye-convalescent okungenani babe neminyaka engu-17 ubudala, banesisindo esingu-110 lbs, futhi bahlangabezane nezidingo zenhlangano zokunikela ngegazi. (Bheka lo mhlahlandlela wokunikeza igazi ukuze ubone ukuthi ukulungele yini ukuhamba ngokusekelwe kulezo zidingo.) Kubalulekile ukuqaphela ukuthi ngezikhathi ezingezona ubhubhane, ungakwazi (futhi, i-TBH, kufanele) futhi unikele nge-plasma ezosetshenziselwa ezinye izindlela zokwelashwa kweziguli ezinomdlavuza kanye nezishile ezishile nezengozi, ngokusho kweNew York Blood Center.

Uhlanganisani Umnikelo We-Plasma We-Convalescent?

Uma usuhlele ukuvakashelwa nesikhungo sakho sendawo seminikelo, sekuyisikhathi sokulungiselela. Konke okuhlanganisayo, nokho, ukuphuza uketshezi olwanele (okungenani i-16oz.) kanye nokudla ukudla okune-protein-nokucebile nge-iron (inyama ebomvu, inhlanzi, ubhontshisi, isipinashi) amahora aholela ekuqokweni kwakho ukuvimbela ukuphelelwa amanzi emzimbeni, ikhanda elilula, kanye isiyezi, ngokusho kwe-American Red Cross.

Uzwakala ujwayelekile? Lokho kungenxa yokuthi ukunikela nge-plasma negazi kufana ncamashi - ngaphandle kwesenzo sokunikela. Uma uke wanikela ngegazi, uyazi ukuthi uketshezi luphuma engalweni yakho luye esikhwameni kanti konke okunye kungumlando. Ukunikela nge-plasma kuthe xaxa, kuyiphutha, kuyinkimbinkimbi. Ngesikhathi somnikelo we-plasma kuphela, igazi lithathwa engalweni eyodwa futhi lithunyelwe ngomshini wobuchwepheshe obuphezulu oqoqa i-plasma bese ubuyisela amangqamuzana egazi abomvu nama-platelet - kanye nosawoti omanzisa amanzi (owaziwa nangokuthi amanzi anosawoti) - abuyele emzimbeni wakho. Lokhu kubalulekile njengoba i-plasma ingamaphesenti angama-92 amanzi, ngokusho kwe-American Red Cross, futhi inqubo yokunikela yandisa ingozi yakho yokuphelelwa amanzi emzimbeni (ngaphezulu kulokhu ngezansi). Yonke inqubo yokunikela kufanele ithathe kuphela ihora nemizuzu eyi-15 (cishe imizuzu eyi-15 kuphela ubude kunomnikelo wegazi kuphela), ngokusho kwe-American Red Cross.

Futhi njengokunikela ngegazi, imiphumela emibi yokunikeza i-plasma incane - ngemuva kwakho konke, kufanele ube nempilo ephelele ukuze ufaneleke kwasekuqaleni. Lokho kushiwo, njengoba kushiwo ngenhla, ukuphela kwamanzi emzimbeni kungenzeka kakhulu. Futhi ngenxa yalesi sizathu, kubalulekile ukuthi ukhuphule umthamo wakho woketshezi ngaphezu kosuku (ama) olulandelayo futhi uyeke ukuphakamisa okunzima nokuzivocavoca umzimba okungenani usuku lonke. Futhi ungakhathazeki ngokuthi umzimba wakho wehla ngoketshezi oluthile olubalulekile, njengoba lungakwazi (futhi lukwenza) esikhundleni somthamo wegazi noma i-plasma phakathi kwamahora angu-48.

Ngokuqondene nengozi yakho ye-COVID-19? Lokho akufanele kube ukukhathazeka lapha. Iningi lezikhungo zokunikela ngegazi zenziwa ngokuqokwa kuphela ukuzama ukuxhasa izindlela ezihamba phambili zokuphambana nomphakathi futhi zisebenzise ezinye izindlela zokuqapha njengoba kuchazwe yiCenters for Disease Control and Prevention (CDC).

Imininingwane ekule ndaba inembile njengesikhathi sokushicilela. Njengoba izibuyekezo ezimayelana ne-coronavirus COVID-19 ziqhubeka nokuvela, kungenzeka ukuthi eminye imininingwane nezincomo kule ndaba zishintshile selokhu kwashicilelwa okokuqala. Sikukhuthaza ukuthi uhlole njalo izinsiza ezifana ne-CDC, i-WHO, kanye nomnyango wezempilo womphakathi wendawo ukuze uthole imininingwane yakamuva nezincomo.

Buyekeza kwe-