Plasmapheresis with corticosteroids and antiviral: a life-saving treatment for severe cases of Covid 19

Abstract

Background: COVID-19 pandemic is a global concern. Unfortunately, there is no exclusive treatment for critical patients to survive. In this study, we suggest using a novel three-dimensional treatment mainly based upon immune system modulation to fix the virus chaos, through cytokine storm as the main character of COVID-19 infection scenario.

Case presentation: A young man infected by SARS-CoV-2 who suffered from respiratory arrest and loss of consciousness, underwent cardiopulmonary resuscitation and endotracheal intubation. Following ICU administration and confirmed diagnosis of COVID-19, considering critical condition of the young patient, plasmapheresis was performed once on a daily basis, three doses of interferon beta(IFN-β-1b) was injected subcutaneously every other day and dexamethasone was given at a dose of 4 mg every 8 hours along with common antiviral regimen. After 2 days, the patient was extubated and transferred from the ICU to the ward where plasmapheresis was performed 4 times daily for 4 days. Finally, after 7 days of hospitalization, the patient was discharged with a good general condition.

Conclusion: We modulated the immune system through plasmapheresis to sweep out the released cytokines. Also, corticosteroid along with interferon was added to common antiviral treatments. Our data suggest that this combined method is effective for critically ill COVID-19 patients.

Keywords: COVID-19; corticosteroid therapy; interferon; therapeutic plasma exchange.

Figure1

Chest CT-scans of case-patient with COVID-19 on March 27, 2020 at the onset of the disease

Figure2

Chest CT-scans of case-patient with COVID-19 on April 2,2020after recovery