Therapeutic plasma exchange followed by convalescent plasma transfusion in critical COVID-19—An exploratory study

Jaiswal, Vinod; Nasa, Prashant; Raouf, May; Gupta, Megha; Dewedar, Hany; Mohammad, Hozaifah; Rais, Zeyad Al; Baqer, Mohamed Ali; Alsabbah, Asad; Ibrahim, Yasser; Salem, Mohamed L.; Shammass, Demme; Marashi, Mahmoud

doi:10.1016/j.ijid.2020.10.085

Cited by 34 publications

(69 citation statements)

References 12 publications

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“…On the other hand, CP therapy is commonly used in infectious diseases [ 10 , 27 ]. CP is enriched with neutralizing antibodies against certain infectious agents and could be beneficial in controlling the infectious agent [ 32 ]. So, the purposes of PE therapy and CP therapy are different.…”

Section: Discussionmentioning

confidence: 99%

Plasma exchange followed by convalescent plasma transfusion in COVID-19 patients

Roshandel

Sankanian

Salimi

et al. 2021

Transfusion and Apheresis Science

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Background Coronavirus disease 2019 (COVID-19) is an emerged pandemic disease with no specific treatment. One of the potential treatments in newly found infectious disease is plasma exchange (PE) with convalescent plasma transfusion (CPT). This case series aimed to evaluate the primary PE and CPT in five Iranian COVID-19 patients. Methods Five patients with confirmed COVID-19 who had acute respiratory distress syndrome and were supported by mechanical ventilation were treated with two consecutive PE containing fresh frozen plasma (FFP) of healthy donors and 0.9 % saline solution containing 5 % human albumin. Thereafter, CPT was performed just like PE, except that the FFP in this step was substituted with convalescent ABO-matched plasma. Clinical and laboratory factors were evaluated before and after treatments. Results Three to Four patients showed lower body temperature and improved oxygen saturation as well as reduced laboratory factors such as c-reactive protein, lactate dehydrogenase, creatine phosphokinase (total and myocardial isoform), aspartate aminotransferase, blood urea nitrogen, bilirubin (total and direct), D-dimer, interleukin-6, and CD4+/CD8 + T cells ratio initially after PE and continued to improve so that they were discharged. One patient due to secondary hemophagocytic lymphohistiocytosis and extensive lung fungal infection was expired. Discussion Overall, the PE followed by CPT was beneficial in reducing acute inflammation led to a considerable improvement in patients’ clinical features. It seems that PE along with CPT could provide clearance of pro-inflammatory mediators as well as the positive effects of CPT. Controlled studies are required to confirm the effect of PE/CPT compared with other therapeutic approaches.

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Section: Discussionmentioning

confidence: 99%

Plasma exchange followed by convalescent plasma transfusion in COVID-19 patients

Roshandel

Sankanian

Salimi

et al. 2021

Transfusion and Apheresis Science

View full text Add to dashboard Cite

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“…After an initial increase, IFN‐γ production decreased again, which could reflect the fact that proinflammatory immune responses shifted to anti‐inflammatory responses 17 . It has already been shown that there was a reduction in proinflammatory cytokines like IL‐6 and an increase in anti‐inflammatory cytokines after CP was administered 18‐20 . Moreover, chronic kidney disease suppressed T‐cell function, which could impede long‐term protection against reinfection 3,21 …”

Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2‐specific humoral and cellular immunity in two renal transplants and two hemodialysis patients treated with convalescent plasma

Lindemann

Krawczyk

Dolff

et al. 2021

Journal of Medical Virology

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“… 19 Other recent exploratory study reported potential therapeutic benefits of CP in the management of COVID-19. 20 Another study involving a course of high-dose methylprednisolone, with or without Tocilizumab, showed a significant acceleration in respiratory recovery, lower hospital mortality and reduced likelihood of invasive mechanical ventilation in COVID-19-associated cytokine storm syndrome. 21 However, no longitudinal studies were reported in the current literature that compared the use of CP or Tocilizumab or both.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the First 102 Severe COVID-19 Cases Treated With Convalescent Plasma or Tocilizumab or Both in Al-Nahdha Hospital, Oman

Harthi

Osali

Kindi

et al. 2021

Health Services Research and Managerial Epidemiology

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Background: In the absence of an effective vaccine, the coronavirus disease (COVID-19) continues to cause more deaths. Evidence on the effectiveness of various COVID-19 management plans is inconclusive. This paper describes the characteristics of the first 102 severe COVID-19 in-patients treated with Convalescent Plasma (CP) therapy or Tocilizumab or both at Al-Nahdha hospital in Muscat, Oman. Additionally, differences in requiring critical care were explored across the treatment groups. Methods: Data of all the positive cases in Al-Nahdha hospital were retrieved from the electronic health information system retrospectively from April 1st to July 31st 2020. The required information was recorded in a bespoke sheet and exported to SPSS for further analysis. The primary outcome was defined as improved (discharged home) vs worsening (requiring critical care). Results: Out of the 102 severe cases of COVID-19 admissions, 20.6%, 59.8% and 20.6% received CP, Tocilizumab and both respectively. In average, CP was introduced at day 3.7(4.8) whereas Tocilizumab at day 7.8(5.1) from admission. The between-group differences in the proportion of patient who improved vs worsened were not significant ( P = 0.7). However, the within-group difference in the proportion of patient who improved vs worsened was significant in the Tocilizumab treatment group ( P = 0.03). All socio-demographics were not significantly different across the treatment groups. Most improvements in the studies parameters [CBC (total WBC, Lymph and neutrophil counts), oxygen and immune response “cytokine storm” parameters] post-treatment was attributed to the use of Tocilizumab. There was a statistically significant difference in the mean hospital stay between the improved and worsened cases across all treatment categories [at the population level: 8.2(5.0) improved vs 4.7(3.7) worsened- P < 0.001]. Conclusions: Results from this study provided baseline information about the characteristics of confirmed COVID-19 cases in Al-Nahdha hospital who received CP, Tocilizumab or both. Results obtained seems to be promising in preventing critical care, especially for Tocilizumab. However, further randomized studies are needed.

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Therapeutic plasma exchange followed by convalescent plasma transfusion in critical COVID-19—An exploratory study

Abstract: Graphical abstract

Cited by 34 publications

References 12 publications

Plasma exchange followed by convalescent plasma transfusion in COVID-19 patients

Plasma exchange followed by convalescent plasma transfusion in COVID-19 patients

SARS‐CoV‐2‐specific humoral and cellular immunity in two renal transplants and two hemodialysis patients treated with convalescent plasma

Characteristics of the First 102 Severe COVID-19 Cases Treated With Convalescent Plasma or Tocilizumab or Both in Al-Nahdha Hospital, Oman

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