Investigation of plasma exchange and hemoperfusion effects and complications for the treatment of patients with severe COVID‐19 (SARS‐CoV‐2) disease: A systematic scoping review

Abstract

Some previous studies suggested that the plasma exchange (PE) and hemoperfusion (HP) played a cardinal role in the treatment of severe coronavirus disease 2019 (COVID‐19) cases by diminishing the cytokine storm. This study aimed to assess the effects of PE and HP on cytokine storms in patients with severe COVID‐19 through a systematic scoping review. Four Electronic databases (Medline [accessed from PubMed], Scopus, Science Direct, and Cochrane library) were searched systematically on February 2, 2021, using MESH terms and related keywords in the English language. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, their findings were assessed and reported. A total of 755 articles were obtained within the first step of searching, and 518 remained after removing the duplications. Through the title and abstract screening, 438 were removed. Of the rest, 59 papers were excluded. Finally, after reading the full text of the remained articles, 21 were included in data extraction. Most of the previously reported evidence were case reports and case series. Findings were summarized in two categories. The first category encompassed nine studies regarding HP and continuous renal replacement therapy, and the second category included twelve studies about PE. The results revealed that HP and PE within the cytokine storm phase would be beneficial with a high probability in the treatment of severely ill COVID‐19 patients. Highlights Some studies showed that plasma exchange (PE) and hemoperfusion (HP) played an important role in the treatment of patients with severe COVID‐19 disease. The results of this systematic scoping review revealed that HP and PE within the cytokine storm phase would be beneficial with a high probability in the treatment of severely ill COVID‐19 patients.

Methanol poisoning during COVID-19 pandemic; A systematic scoping review

“…On the other hand, ethanol is second-line for treatment when fomepizole is unavailable [ 10 ]. Also, hemodialysis can improve hospital outcomes with toxin elimination [ 33 , 38 , 43 ].…”

Coronavirus Disease 2019-Associated Thrombotic Microangiopathy

“…As these antibodies could be removed by TPE [ 43 ], it was proposed that TPE would be of benefit in critically ill COVID-19-infected patients in general, not only in those with TMA [ 44 ]. A meta-analysis of several case reports and small series confirmed the beneficial effects of TPE in COVID-19 [ 45 ]. However, a newly published large-scale prospective study of the use of TPE in COVID-19 was not as positive [ 46 ].…”

How effective is rescue therapeutic plasma exchange in treatment of SARS‐Coronavirus‐2?

“…Therefore, some felt TPE should be “employed on patients that have no significant response for typical anti‐viral, ARDS and conservative therapies, and the disease persists or progresses despite sufficient therapies [ 27 ].” A recently published critical analysis of all previous case series has concluded that despite some individual successes with TPE in SARS‐CoV‐2 virus infection, we still do not know how or if it is really effective [ 30 ]. Furthermore, a soon to be published metanalysis of all available published use of therapeutic plasma exchange found that only a total of 49 critically ill patients with SARS‐CoV‐2 have been treated with therapeutic plasma exchange but yet they have concluded that the treatment is helpful [ 31 ]. The paucity of data for just 49 patients in this life threatening situation leaves one dubious.…”