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. 2020 Aug;56(2):105974.
doi: 10.1016/j.ijantimicag.2020.105974. Epub 2020 Apr 13.

Successful treatment with plasma exchange followed by intravenous immunoglobulin in a critically ill patient with COVID-19

Hua Shi  1 , Chaomin Zhou  2 , Pinghong He  2 , Sheng Huang  3 , Youjun Duan  3 , Xuesheng Wang  3 , Kexiong Lin  3 , Chao Zhou  3 , Xiangyan Zhang  4 , Yan Zha  5
Affiliations

Successful treatment with plasma exchange followed by intravenous immunoglobulin in a critically ill patient with COVID-19

Hua Shi et al. Int J Antimicrob Agents. 2020 Aug.

Abstract

Here we report a case of a laboratory-confirmed 2019 novel coronavirus (2019-nCoV)-infected patient with COVID-19 (coronavirus disease 2019) who developed respiratory failure and shock accompanied by persistent diarrhoea despite conventional therapeutic interventions. The patient avoided mechanical ventilation and showed an immediate clinical and radiological improvement following treatment with intensive plasma exchange (PE) followed by intravenous immunoglobulin (IVIG). Successful therapeutic strategies in this case suggest that timely initiation of PE treatment followed by IVIG in critically ill patients with COVID-19 may prevent the disease from worsening and help to reduce the requirement for mechanical ventilation and intensive supportive care. Moreover, it may improve poor clinical outcomes of these patients.

Keywords: 2019 novel coronavirus; COVID-19; Diarrhoea; Immunoglobulin; Plasma exchange; SARS-CoV-2.

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Figures

Fig 1
Fig. 1
Clinical course of the patient according to day of illness (DOI) and day of hospitalisation, 10 January 2020 to 5 February 2020.
Fig 2
Fig. 2
Transverse and longitudinal chest computed tomography (CT) images of the patient from day of illness (DOI) 11 to 23.
See this image and copyright information in PMC

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