The association between therapeutic plasma exchange and the risk of mortality among patients critically ill with COVID-19: a meta-analysis

Abstract

Background: Cytokine storm has been widely known to contribute to the development of the critical condition in patients with coronavirus disease 2019 (COVID-19), and studies had been conducted to assess the potential aspect of cytokine storm elimination by performing therapeutic plasma exchange (TPE). However, contradictory findings were observed. The objective of this study was to assess the association between TPE and the reduction of mortality of critically ill COVID-19 patients. Methods: A meta-analysis was conducted by collecting data from PubMed, Scopus, and Web of Science. Data on the mortality rate of critically ill COVID-19 patients treated with TPE plus standard of care and that of patients treated with standard of care alone were analyzed using a Z test. Results: We included a total of four papers assessing the association between TPE and the risk of mortality among critically ill COVID-19 patients. Our findings suggested that critically ill COVID-19 patients treated with TPE had lower risk of mortality compared to those without TPE treatment. Conclusion: Our study has identified the potential benefits of TPE in reducing the risk of mortality among critically ill COVID-19 patients.

Keywords: COVID-19; therapeutic plasma exchange; cytokine storm; treatment.

Figure 1.. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of article selection in our meta-analysis.

Figure 2.. Forest plot of mortality rate between therapeutic plasma exchange vs control (OR: 0.2097; 95% CI: 0.0516, 0.852; p-value: 0.0382; pHet: 0.2065; pE: 02153).