Therapeutic plasma exchange followed by convalescent plasma transfusion in critical COVID-19—An exploratory study

International Journal of Infectious Diseases

卷:102

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