Efficacy of therapeutic plasma exchange in severe COVID‐19 patients

Zhang, Li; Zhai, Hua‐Jin; Ma, Sai; Chen, Jiasheng; Gao, Yu Tang

doi:10.1111/bjh.16890

Cited by 61 publications

(113 citation statements)

References 10 publications

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“…Additionally, therapeutic plasma exchange can reduce the plasma cytokine concentrations rapidly, and has been successfully used to treat HLH and CRS related to CAR T cells infusion (22,23), suggesting plasma exchange may be a reasonable option for severe patients with cytokine storm. In a preliminary study, therapeutic plasma exchange reduced the plasma IL-6 level and improved the oxygenation status in patients with severe COVID-19 who had ARDS (24).…”

Section: Potential Treatmentsmentioning

confidence: 97%

Potential Treatments for COVID-19 Related Cytokine Storm - Beyond Corticosteroids

Miao

Fan

2020

Front. Immunol.

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A novel virus, SARS-CoV-2, emerged in Wuhan in December 2019 and rapidly spread to other cities in China and other countries. Several studies have summarized the clinical characteristics and laboratory findings of patients with Corona Virus Disease 2019 (COVID-19) (1, 2). According to these studies, in addition to lung injury, damages involving other organs, which include liver, kidney, heart, and hemopoietic system, were also observed in some patients, suggesting the presence of systemic inflammation, and from the work by Huang et al. (1), we noted that elevation of various proinflammatory cytokines was present in patients infected with SARS-CoV-2, suggesting the possible existence of cytokine storm in a proportion of patients. Further, patients that require intensive care unit (ICU) admission showed higher concentrations of certain cytokines compared with those not requiring ICU admission, indicating that the levels of proinflammatory cytokines were associated with disease severity. Further studies confirmed that levels of cytokines including interleukin (IL)-6 and IL-8 correlated with the disease severity of COVID-19 (3, 4). This phenomenon is not restricted to COVID-19, in the previous studies regarding the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), higher levels of certain cytokines were associated with increased mortality (5, 6). For instance, high IL-6 concentration predicted mortality in patients with MERS (5). In patients infected with pathogenic human coronaviruses, cytokine storm contributes to acute lung injury and acute respiratory distress syndrome (ARDS) (7). Therefore, controlling the cytokine storm might be a strategy for treating patients with COVID-19, especially for those severe cases.

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Section: Potential Treatmentsmentioning

confidence: 97%

Potential Treatments for COVID-19 Related Cytokine Storm - Beyond Corticosteroids

Miao

Fan

2020

Front. Immunol.

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“…Several authors have suggested plasma exchange with CP (i.e., high-volume therapeutic plasmapheresis followed by CP transfusion) rather than CP transfusion alone in order to clear proinflammatory cytokines from the bloodstream ( 108 , 109 ), and several successful case reports deploying nonconvalescent plasma have been reported ( 110 – 112 ). One randomized controlled trial (NCT04374539) is ongoing in patients with severe COVID-19, but unfortunately no trial to date is testing plasmapheresis followed by CP.…”

Section: Convalescent Plasma For Covid-19mentioning

confidence: 99%

Convalescent Plasma Therapy for COVID-19: State of the Art

Focosi¹,

et al. 2020

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SUMMARY Convalescent plasma (CP) therapy has been used since the early 1900s to treat emerging infectious diseases; its efficacy was later associated with the evidence that polyclonal neutralizing antibodies can reduce the duration of viremia. Recent large outbreaks of viral diseases for which effective antivirals or vaccines are still lacking has renewed the interest in CP as a life-saving treatment. The ongoing COVID-19 pandemic has led to the scaling up of CP therapy to unprecedented levels. Compared with historical usage, pathogen reduction technologies have now added an extra layer of safety to the use of CP, and new manufacturing approaches are being explored. This review summarizes historical settings of application, with a focus on betacoronaviruses, and surveys current approaches for donor selection and CP collection, pooling technologies, pathogen inactivation systems, and banking of CP. We additionally list the ongoing registered clinical trials for CP throughout the world and discuss the trial results published thus far.

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“…Surprisingly, we did not receive any request of consultation for application of TPE as a rescue therapy in severe COVID-19 patients, as recently published [15].…”

Section: Discussionmentioning

confidence: 82%

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

Colpo

Astolfi²,

Tison

et al. 2020

Transfusion and Apheresis Science

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The recent Coronavirus Disease 2019 (COVID-19) outbreak has led to profound and rapid changes in the Italian and Veneto Region Healthcare System. This context also includes the quick reorganization which the Apheresis Unit (AU) of the Padova University Hospital, i.e. the Regional Reference Center for Therapeutic Apheresis (TA), had to face. Material and Methods: The study retrospectively evaluated the TA activity (procedures performed, patients treated and consultations) during the COVID-19 pandemic, from March to April 2020, comparing the activity in the same time period in 2018 and 2019. Results: In the period analyzed, a significant reduction in both the total number of procedures performed and of patients treated, respectively by 17 % and 16 % for the procedures and by 19 % and 20 % for patients treated compared to the same period of 2018 and 2019, respectively, was observed. A concomitant reduction in requests for TA consultation for new patients (both outpatients and inpatients) was observed, equal to 32 % and 21 % compared to 2018 and 2019, respectively. Conclusion: Many reasons determined the observed reduction in the TA activity during the recent COVID-19 outbreak. The AU itself was quickly reorganized in terms of location and supplies to allow for the appropriate COVID-19 patients care. Many non urgent cases, after multidisciplinary discussion between Clinicians and Apheresis Specialists, were deferred, maintaining close phone and e-mail contact with patients.

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Efficacy of therapeutic plasma exchange in severe COVID‐19 patients

Cited by 61 publications

References 10 publications

Potential Treatments for COVID-19 Related Cytokine Storm - Beyond Corticosteroids

Potential Treatments for COVID-19 Related Cytokine Storm - Beyond Corticosteroids

Convalescent Plasma Therapy for COVID-19: State of the Art

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

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