Get rid of the bad first: Therapeutic plasma exchange with convalescent plasma for severe COVID-19

Kesici, Selman; Yavuz, Sinan; Bayrakçı, Benan

doi:10.1073/pnas.2006691117

Cited by 36 publications

(40 citation statements)

References 8 publications

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“…Because after the cascade effect of inflammatory factors, the efficiency of deposition may be limited. Timing of immunomodulatory treatments in cases with hypercytokinemia is crucial, and early initiation of treatment is in line with better outcome [3]. Nonetheless, in need, the administration of existing autologous antibodies collected from recovered COVID 19 patients, to provide immediate passive immunity, must always be kept in mind [11].…”

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confidence: 99%

“…During this fight against pandemic, to reduce mortality it's inevitable that novel treatment and passive immunity options for severe cases are urgently needed until vaccines for COVID-19 are available [3]. We believe that plasmapheresis and convalescent plasma plays crtitical role in the management of severe COVID-19 patients without suppressing immune system or in combination with immunsupressive agents.…”

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confidence: 99%

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The successful management of an elderly Covid-19 infected patient by plasmapheresis

Akkoyunlu

Çetin

Bölükçü

et al. 2020

Transfusion and Apheresis Science

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Letter to the Editor The successful management of an elderly Covid-19 infected patient by plasmapheresis Dear Editor, Coronavirus disease 2019 (COVID-19) is a pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China since December 2019. The epidemic spread rapidly worldwide, became a global threat and was characterized as a pandemic on March 11, 2020 by World Health Organization (WHO) [1]. It is not just a viral pneumonia, it can also cause a multisystemic disorder called COVID-19 immune syndrome [2]. In severe COVID-19 patients it was reported that the pro-inflammatory cytokins, mainly IL-6, IL-10, TNF-α were significantly increased around 7-14 days after onset, named as cytokine storm, which is also associated with the aggravation of disease and higher mortality [3,4]. Furthermore, most of these patients have already been in an induced-hypercoagulable state and predisposed to thrombosis. Currently, there isn't any specific effective and approved antiviral treatment for COVID-19 [5]. There aren't sufficient randomized controlled trials and so strong recommendations for the management of COVID-19 even from the international societies [2]. For better results and lower mortality rates, clinicians must both control the viral replication and also optimize the immun response. Plasmapheresis can take place successfully in the management of these patients with the use of anticoagulants and removal of both the inflammatory molecules and high molecular weight viscous components [6]. We want to emphasize the role of plasmapheresis by a critically ill Covid-19 patient whose clinical status worsen despite antiviral and tocilizumab treatments and who was successfully managed via performing plasmapheresis. A 65 year old female patient complaining of cough, myalgia and fatigue was admitted to our clinic who had a history of contact with a confirmed Covid-19 case. She had 3 comorbities: asthma, hypertension and type 2 Diabetes Mellitus. Her SARS-CoV-2 PCR test resulted negative, but her chest computed thomography(CT) revealed two small ground glass opacities in both lungs, which indicated COVID-19 pneumonia. According to our national Covid-19 treatment guidelines provided by the Ministry of Health, she was given hydroxychloroquine, azitromycine and oseltamivir. During hospital follow up, her maximum body temperature was 37.8 • C; all other vital signs were normal. Laboratory findings are summarized in Table 1. She completed the treatment schedule and was discharged from hospital after 5 days. On 10th day of the symptom onset she was readmitted to hospital with fever, cough, sputum and shortness of breath. Her fever was 38.5 • C, hearth rate was 118beats/min, respiratory rate was 26/min, blood pressure was 156/84 mmHg and oxygen saturation was 88 % at room air with intermittent prone positioning. Her thorax CT revealed bilateral multiple ground glass infiltrations (Fig. 1). Favipravir, enoxaparine prophylaxis, ceftriaxone and oxygen supplementation of 3 L/min were initiated. Laborat...

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confidence: 99%

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The successful management of an elderly Covid-19 infected patient by plasmapheresis

Akkoyunlu

Çetin

Bölükçü

et al. 2020

Transfusion and Apheresis Science

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“…1 B ) for children with and without SARS-CoV-2. However, for children with COVID-19 and PIMS-TS/MIS-C, the potential benefits of select adjunctive therapies, such as corticosteroids, anticoagulation, plasma exchange, IV immunoglobulins, convalescent plasma, and other immunotherapies, may differ from non-COVID-19 sepsis ( 6 , 24 – 28 ). Given the current uncertainty of such therapies, early consultation with additional subspecialists, such as rheumatology, cardiology, and hematology, is appropriate in acute COVID-19 and PIMS-TS/MIS-C.…”

Section: Application Of Surviving Sepsis Campaign Guidelinesmentioning

confidence: 99%

Perspective of the Surviving Sepsis Campaign on the Management of Pediatric Sepsis in the Era of Coronavirus Disease 2019*

Weiss¹,

Peters

Agus³

et al. 2020

Pediatric Critical Care Medicine

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Severe acute respiratory syndrome coronavirus 2 is a novel cause of organ dysfunction in children, presenting as either coronavirus disease 2019 with sepsis and/or respiratory failure or a hyperinflammatory shock syndrome. Clinicians must now consider these diagnoses when evaluating children for septic shock and sepsis-associated organ dysfunction. The Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-associated Organ Dysfunction in Children provide an appropriate framework for the early recognition and initial resuscitation of children with sepsis or septic shock caused by all pathogens, including severe acute respiratory syndrome coronavirus 2. However, the potential benefits of select adjunctive therapies may differ from non-coronavirus disease 2019 sepsis.

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“…We appreciate the constructive comments from Kesici et al (1) and Zeng et al (2), which mainly focus on the key points about the optimal procedure of convalescent plasma (CP) transfusion in severe coronavirus disease 2019 (COVID-19) therapy and about how to improve the effectiveness.…”

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confidence: 99%

Reply to Kesici et al. and Zeng et al.: Blocking the virus and reducing the inflammatory damage in COVID-19

Duan¹,

Liu

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

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Get rid of the bad first: Therapeutic plasma exchange with convalescent plasma for severe COVID-19

Cited by 36 publications

References 8 publications

The successful management of an elderly Covid-19 infected patient by plasmapheresis

The successful management of an elderly Covid-19 infected patient by plasmapheresis

Perspective of the Surviving Sepsis Campaign on the Management of Pediatric Sepsis in the Era of Coronavirus Disease 2019*

Reply to Kesici et al. and Zeng et al.: Blocking the virus and reducing the inflammatory damage in COVID-19

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