Role of therapeutic plasma exchange in the management of COVID-19-induced cytokine storm syndrome

Beraud, Mickael; Hashami, Sabria Al; Lozano, Miquel; Bah, Aïcha; Keith, Philip

doi:10.1016/j.transci.2022.103433

Cited by 23 publications

(18 citation statements)

References 85 publications

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“…Accordingly, it seems that these therapies have the same therapeutic effectiveness in patients with severe COVID-19 based on the findings of this research. Other studies reported the efficacy of plasmapheresis treatment or Tocilizumab [16] , [17] , [21] The use of plasmapheresis in the treatment of COVID-19 patients was linked to clinical improvement in patients with severe illness and lowered blood levels of inflammatory markers [32] . In another study, 22 patients with severe coronary artery disease were treated with three plasmapheresis sessions and compared with the control group that showed clinical improvement and further reduction in serum levels of inflammatory factors were seen in the group treated with plasmapheresis [33] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial

Jelodar

Rafieian

Saghafi

et al. 2023

International Immunopharmacology

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial

Jelodar

Rafieian

Saghafi

et al. 2023

International Immunopharmacology

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“…COVID‐19 is caused by SARS‐CoV‐2 and has caused a global pandemic. Although most patients have mild symptoms, mortality remains high in critically ill patients, which may be largely attributable to an overactive immune response rather than the viral infection itself 26 . This excessive inflammatory response, commonly referred to as cytokine storm syndrome or CRS, manifests as high fever, elevated CRP and ferritin levels, and cytopenias 14,27 that can lead to lung damage, ARDS, multiple organ dysfunction syndrome, sepsis, and ultimately death 28–30 …”

Section: Discussionmentioning

confidence: 99%

“…attributable to an overactive immune response rather than the viral infection itself. 26 This excessive inflammatory response, commonly referred to as cytokine storm syndrome or CRS, manifests as high fever, elevated CRP and ferritin levels, and cytopenias 14,27 that can lead to lung damage, ARDS, multiple organ dysfunction syndrome, sepsis, and ultimately death. [28][29][30] F I G U R E 2 Forest plot assessing the efficacy of anakinra on (a) 14-day mortality, (b) 28-day mortality, and (c) 90-day mortality.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Anakinra was not associated with lower mortality in hospitalised COVID‐19 patients: A systematic review and meta‐analysis of randomized controlled trials

Shang

Zhang

Wang

et al. 2023

Reviews in Medical Virology

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The Coronavirus disease‐2019 (COVID‐19) pandemic continues, and the death toll continues to surge. This meta‐analysis aimed to determine the efficacy of anakinra on mortality in patients with COVID‐19. A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials on treatment of COVID‐19 with anakinra, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs), with 95% confidence intervals (CIs). Five Randomized controlled trials (enrolling 1859 participants) met the inclusion criteria. There was no statistically significant difference in 14‐day mortality (RR 0.78, 95% CI 0.43–1.39; P = 0.40), 28‐day mortality (RR 1.06, 95% CI 0.89–1.26; P = 0.51), and 90‐day mortality (RR 1.01, 95% CI 0.73–1.39; P = 0.97) between the two groups. Sensitivity analyses further confirmed these results. Anakinra was not associated with reduced mortality in hospitalised patients with COVID‐19. Anakinra probably should not be used routinely in COVID‐19 patients.

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“…12 In COVID-19 patients, TPE will eliminate anti-fibrinolytic mediators and reform anticoagulant proteins. 13 Antithrombotic properties of CP performed by substitution of missing coagulation factors and immunomodulatory action. Antiphospholipid antibodies are one of the autoantibodies that are neutralized by CP and lead to inhibition of the thrombotic process.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of therapeutic plasma exchange and convalescent plasma therapy in moderate-to-severe COVID-19 patients

et al. 2022

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Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health catastrophe since its first reported cases in late December 2019. Critically ill COVID-19 patients have been related to cytokine storms leading to acute respiratory distress syndrome and high mortality rates. Therapeutic plasma exchange (TPE) and convalescent plasma (CP) therapy improve clinically by removing inflammatory cytokines excess and using passive antibody-containing blood, respectively. This study aimed to evaluate TPE and CP treatment for moderate-to-severe COVID-19 infection. Method: The patients were randomly divided into TPE group (n = 10), CP group (n = 11), and control group (n = 10). This 1-week quasi-experimental study with a pretest–post-test control group design was conducted in the Intensive Care Unit (ICU) of Dr. Moewardi General Hospital and Universitas Sebelas Maret (UNS) Hospital. The study comparison between groups included blood gas analysis profile (pH, base excess, PaCO2, PaO2, hematocrit, HCO3, total CO2, SaO2), FiO2, P/F ratio, COVID-19 severity, and D-dimer. The paired t-test was used to analyze every group's pretest–post-test mean difference. One-way ANOVA was performed to analyze the mean difference across the three groups. SPSS version 22.0 for Windows was used to perform statistical analyses. Result: TPE and CP groups showed significant clinical-laboratory improvement than control (p > 0.05). Furthermore, high clinical-laboratory improvement tendency was observed in CP therapy than TPE. Conclusion: The use of TPE and CP in moderate-to-severe COVID-19 patients has been related to improving clinical-laboratory outcomes.

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Role of therapeutic plasma exchange in the management of COVID-19-induced cytokine storm syndrome

Cited by 23 publications

References 85 publications

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial

Anakinra was not associated with lower mortality in hospitalised COVID‐19 patients: A systematic review and meta‐analysis of randomized controlled trials

Efficacy of therapeutic plasma exchange and convalescent plasma therapy in moderate-to-severe COVID-19 patients

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