Automatic Plasmapheresis in Patients With Covid-19-Associated Pneumonia. The First Experience of Application

Abstract

Objective. To determine the possibility of using automatic plasmapheresis in patients with COVID-19- associated bilateral polysegmental pneumonia. Methods. The treatment of three patients with COVID-19-associated pneumonia with application of the Autopheresis-C™ automatic plasmapheresis machine (the USA) has been analyzed. The patients’ age was 47. 49 and 55 years. The patients’ case histories included factors aggravating the course of pneumonia (diabetes mellitus, chronic cardiovascular pathology with heart failure, obesity). The condition of all patients was severe. The effectiveness estimation of the given technique was carried out 6 hours after the manipulation and included a general clinical blood test, a biochemical blood test, hemodynamic parameters, and objective data. Results. After the first application of automatic plasmapheresis, all patients occurred a decrease in temperature and the level of respiratory failure, which was accompanied by an increase in hemoglobin saturation; a decrease in the severity of dyspnea was also reported, which was the reason for the changing patient position from prone to supine. All patients had a blood pressure reduction. Positive changes in the hemodynamic situation were the basis for reducing the dosage of antihypertensive drugs. Along with this, in the course of manipulation, a gradual decrease in the severity of tachycardia was noted in all patients: a reduction of heart rate was recorded. On the second day after the manipulation, the main blood parameters (leukocytosis, c-reactive protein) decreased. The observed positive effects contributed to the early transfer (by 10-15 days) of patients from the intensive care unit to the general somatic departments. Conclusion. The early inclusion of automatic plasmapheresis in the complex therapy of patients with COVID-19- associated bilateral polysegmental pneumonia leads to the stabilization of hemodynamic parameters, decline of the severity of respiratory failure, which made it possible to avoid the mechanical ventilation. What this paper adds For the first time, the clinical effectiveness of the method of automatic plasmapheresis in the framework of the complex therapy of COVID-19- associated polysegmental pneumonia is shown, which is expressed in a decrease in the manifestations of functional and metabolic disorders of vital systems for maintaining homeostasis. It was found that the inclusion of this technology in the complex therapy contributed to the stabilization of respiratory and hemodynamic parameters, which made it possible to avoid the mechanical ventilation.