The Use of Therapeutic Plasma Exchange in the Treatment of a Pregnant Woman with COVID-19 Induced Acute Respiratory Distress Syndrome

Duong-Quy, Sy; Huynh-Truong-Anh, Duc; Nguyen-Thi-Kim, Thanh; Nguyen-Quang, Tien; Nguyen-Chi, Thanh; Nguyen-Thi-Y, Nhi; Duong-Thi-Thanh, Van; Craig, Timothy J.

doi:10.1007/s41030-022-00188-7

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…Clinical and serologic phenotyping of patients with PC19-PF, as well as comprehensive epidemiologic identification of particular risk variables, should be pursued as additional research directions. Longer follow-up studies are needed to determine how PC19-PF progresses and what the best long-term approach is for such patients, especially for those with ARDS, during the acute stage of COVID-19 infection [ 51 , 52 ].…”

Section: Future Considerationsmentioning

confidence: 99%

Post-COVID-19 Pulmonary Fibrosis: Facts—Challenges and Futures: A Narrative Review

Duong-Quy,

Vo-Pham-Minh,

Tran-Xuan

et al. 2023

Pulm Ther

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Patients with coronavirus disease 2019 (COVID-19) usually suffer from post-acute sequelae of coronavirus disease 2019 (PASC). Pulmonary fibrosis (PF) has the most significant long-term impact on patients’ respiratory health, called post-COVID-19 pulmonary fibrosis (PC19-PF). PC19- PF can be caused by acute respiratory distress syndrome (ARDS) or pneumonia due to COVID-19. The risk factors of PC19-PF, such as older age, chronic comorbidities, the use of mechanical ventilation during the acute phase, and female sex, should be considered. Individuals with COVID-19 pneumonia symptoms lasting at least 12 weeks following diagnosis, including cough, dyspnea, exertional dyspnea, and poor saturation, accounted for nearly all disease occurrences. PC19-PF is characterized by persistent fibrotic tomographic sequelae associated with functional impairment throughout follow-up. Thus, clinical examination, radiology, pulmonary function tests, and pathological findings should be done to diagnose PC19-PF patients. PFT indicated persistent limitations in diffusion capacity and restrictive physiology, despite the absence of previous testing and inconsistency in the timeliness of assessments following acute illness. It has been hypothesized that PC19-PF patients may benefit from idiopathic pulmonary fibrosis treatment to prevent continued infection-related disorders, enhance the healing phase, and manage fibroproliferative processes. Immunomodulatory agents might reduce inflammation and the length of mechanical ventilation during the acute phase of COVID-19 infection, and the risk of the PC19-PF stage. Pulmonary rehabilitation, incorporating exercise training, physical education, and behavioral modifications, can improve the physical and psychological conditions of patients with PC19-PF.

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Section: Future Considerationsmentioning

confidence: 99%

Post-COVID-19 Pulmonary Fibrosis: Facts—Challenges and Futures: A Narrative Review

Duong-Quy,

Vo-Pham-Minh,

Tran-Xuan

et al. 2023

Pulm Ther

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“…In patients with severe COVID-19, TPE might be considered an efficient therapy for reducing the risk of cytokine storm-induced ARDS as it might reduce the inflammatory cytokines (including IL-6) and acute phase proteins (ferritin and CRP). This could help in improving tissue oxygenation and reducing the risk of hypercoagulation and improve tissue oxygenation and especially fatal cardiovascular events ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Bradycardia unresponded to atropin testing was successfully treated with therapeutic plasma exchange in a patient with severe COVID-19 complicated by Guillain-Barré syndrome: A case report

Duong‐Quy

Huynh-Truong-Anh²,

Tran-Xuan

et al. 2023

Front. Cardiovasc. Med.

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been an alarming situation worldwide for the past 2 years. The symptoms of coronavirus disease 2019 (COVID-19) are not only confined to the respiratory system but also affect a multitude of organ systems. Bradycardia associated with Guillain-Barré syndrome (GBS) is a rare autonomic and peripheral neurological complication of COVID-19. In this case report, we present the case of a 26-year-old man diagnosed with bradycardia associated with GBS after contracting COVID-19. Initially, this patient had the classical symptoms of COVID-19 and was hospitalized in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS). Then, he developed weakness in the lower extremities, diminished tendon reflexes, a loss of sensation without sphincter muscle disorders, and bradycardia. His bradycardia did not respond to atropine. The patient was treated concurrently with a high-flow nasal cannula, systemic corticosteroids, anticoagulation, and therapeutic plasma exchange (TPE) for COVID-19-induced ARDS, bradycardia, and GBS. His ARDS and bradycardia improved after the first cycle of TPE and medical treatment. After three cycles of TPE, the patient progressively recovered his muscle strength in the lower limbs and regained peripheral sensation. He was discharged from the hospital in stable condition after 4 weeks of hospitalization and was followed up after 6 months for cardiorespiratory and neurological complications. This case report elucidates the potential difficulties and challenges that physicians may encounter in diagnosing and treating COVID-19-induced bradycardia and GBS during the pandemic outbreak. However, the patient outcomes with the treatment combining the conventional treatment with therapeutic plasma exchange seem to be optimistic.

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“…The use of convalescent plasma (CP), also known as hyperimmune plasma, for treating COVID-19 has been widely studied. The mechanism of action of hyperimmune plasma is based on its ability to remove high-weight molecules from the blood, including antibodies, cytokines, and fibrin degradation products [67]. Convalescent plasma was first used in the late 19th century, even before the discovery of antibiotics, to treat several infectious diseases [68].…”

Section: Convalescent Plasmamentioning

confidence: 99%

“…There are several case reports of pregnant women with COVID-19 being treated with hyperimmune plasma. Specifically, in these case reports, the patients were affected by a severe infection and required oxygen to maintain acceptable saturation [67,68]. As reported by the first systematic review of the literature regarding the treatment of COVID-19 with CP in pregnancy, the treatment was administered to twelve pregnant women affected by severe and mild Acute Respiratory Distress Syndrome (ARDS); in this group, two women had one comorbid condition (obesity), and five had multiple comorbid conditions.…”

Section: Convalescent Plasmamentioning

confidence: 99%

COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies

Favilli

Gentili

Paola

et al. 2023

JPM

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The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered. Ongoing assessment of the safety and effectiveness of pharmacological therapies is crucial in clinical practice. This narrative review summarizes the evidence-based therapeutic strategies for pregnant women with COVID-19, considering over three years of pandemic experience. The review discusses the safety and effectiveness of various drug regimens (antivirals, anticoagulants, corticosteroids, immunoglobulins, monoclonal antibodies, and therapeutic gases) and procedures (prone positioning and extracorporeal membrane oxygenation). Drugs with contraindications, inefficacy during pregnancy, or unknown adverse effects were excluded from our evaluation. The aim is to provide healthcare professionals with a comprehensive guide for managing pregnant women with COVID-19 based on lessons learned from the pandemic outbreak.

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The Use of Therapeutic Plasma Exchange in the Treatment of a Pregnant Woman with COVID-19 Induced Acute Respiratory Distress Syndrome

Cited by 10 publications

References 23 publications

Post-COVID-19 Pulmonary Fibrosis: Facts—Challenges and Futures: A Narrative Review

Post-COVID-19 Pulmonary Fibrosis: Facts—Challenges and Futures: A Narrative Review

Bradycardia unresponded to atropin testing was successfully treated with therapeutic plasma exchange in a patient with severe COVID-19 complicated by Guillain-Barré syndrome: A case report

COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies

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