International Journal of Infectious Diseases | 卷:102 |
Therapeutic plasma exchange followed by convalescent plasma transfusion in critical COVID-19—An exploratory study | |
May Raouf1  Prashant Nasa2  Yasser Ibrahim3  Asad Alsabbah3  Mahmoud Marashi3  Mohamed Ali Baqer3  Demme Shammass3  Mohamed Salem3  Vinod Jaiswal3  Hany Dewedar4  Megha Gupta5  Zeyad Al Rais6  Hozaifah Mohammad7  | |
[1] Corresponding author.; | |
[2] Critical Care Medicine, NMC Specialty Hospital, Dubai, United Arab Emirates; | |
[3] Department of ICU, Mediclinic City Hospital, Dubai, United Arab Emirates; | |
[4] Department of Obstetrics and Gynaecology, Al Zahra Hospital, Dubai, United Arab Emirates; | |
[5] Dubai Blood Donation Center, Dubai, United Arab Emirates; | |
[6] Rashid Hospital, Dubai, United Arab Emirates; | |
[7] Thalassemia Center, Latifa Hospital, Dubai, United Arab Emirates; | |
关键词: COVID-19; Therapeutic plasma exchange; Convalescent plasma; ARDS; SARS-CoV-2; Critical COVID-19; | |
DOI : | |
来源: DOAJ |
【 摘 要 】
The pathophysiology of severe coronavirus disease 2019 (COVID-19) is primarily a host immune interplay to virus invasion. The therapeutic options have been explored either against hyperinflammation from dysregulated adaptive immunity or direct virus neutralization using antibodies from convalescent plasma (CP) of a recovered patient. The therapeutic plasma exchange (TPE) for removal of excessive inflammatory cytokines has been tried with success in COVID-19. We undertook this exploratory study to evaluate safety and efficacy of TPE followed by CP transfusion in 14 patients with critical COVID-19 requiring invasive mechanical ventilation (IMV). All patients showed improvement in symptoms and decrease of inflammatory markers especially CRP (p = 0.03). 10 patients were liberated from IMV after a median of 5.5 (3–36) days, post sequential therapy. Day 7 and Day 28 mortality was 21.4% and 28.6% respectively. The median duration ICU and hospital LOS were 12 (5−42) days and 18 (12−47) days respectively. No patient developed transfusion-associated complications, but three patients developed secondary bacterial sepsis within 14 days of therapy, and one died.This case series demonstrated the sequential use of TPE followed by CP transfusion as a therapeutic option in critical COVID-19.
【 授权许可】
Unknown