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. 2022 Nov 23;58(12):1707.
doi: 10.3390/medicina58121707.

Efficacy of Therapeutic Plasma Exchange in Severe Acute Respiratory Distress Syndrome in COVID-19 Patients from the Western Part of Romania

Tamara Mirela Porosnicu  1 , Ciprian Gindac  2 , Sonia Popovici  2 , Adelina Marinescu  3 , Daniel Jipa  2 , Valentina Lazaroiu  4 , Dorel Sandesc  5 , Cristian Oancea  6 , Roxana Folescu  7 , Alexandra-Simona Zamfir  8 , Carmen Lacramioara Zamfir  9 , Laura Alexandra Nussbaum  10 , Ioan Ovidiu Sirbu  1
Affiliations

Efficacy of Therapeutic Plasma Exchange in Severe Acute Respiratory Distress Syndrome in COVID-19 Patients from the Western Part of Romania

Tamara Mirela Porosnicu et al. Medicina (Kaunas). .

Abstract

Background and Objectives: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has surprised the medical world with its devastating effects such as severe acute respiratory distress syndrome (ARDS) and cytokine storm, but also with the scant therapeutic solutions which have proven to be effective against the disease. Therapeutic plasma exchange (TPE) has been proposed from the very beginning as a possible adjuvant treatment in severe cases. Our objective was to analyze the evolution of specific biological markers of the COVID-19 disease before and one day after a therapeutic plasma exchange session, how a change in these parameters influences the patient’s respiratory status, as well as the impact of TPE on the survival rate. Materials and Methods: In this retrospective study, we include 65 patients with COVID-19 admitted to the intensive care unit department of our hospital between March 2020 and December 2021, and who received a total of 120 sessions of TPE. Results: TPE significantly reduced the following inflammation markers (p < 0.001): interleukin-6 (IL-6), C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, ferritin, and erythrocyte sedimentation rate. This procedure significantly increased the number of lymphocytes and decreased D-dimers levels (p = 0.0024). TPE significantly improved the PaO2/FiO2 ratio (p < 0.001) in patients with severe acute respiratory distress syndrome (PaO2/FiO2 < 100). Survival was improved in intubated patients who received TPE. Conclusions: TPE involved the reduction in inflammatory markers in critical patients with COVID-19 disease and the improvement of the PaO2/FiO2 ratio in patients with severe ARDS and had a potential benefit on the survival of patients with extremely severe COVID-19 disease.

Keywords: ARDS; COVID-19; inflammatory markers; survival; therapeutic plasma exchange.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
TPE impact on the PaO2/FiO2 ratio in patients with severe ARDS (55 sessions).
Figure 2
Figure 2
TPE impact on PaO2/FiO2 ratio in patients with non-severe ARDS (55 sessions).
Figure 3
Figure 3
Survival in ICU: total COVID patients versus COVID patients with/without TPE.
See this image and copyright information in PMC

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References

    1. Ranieri V.M., Rubenfeld G.D., Thompson B.T., Ferguson N.D., Caldwell E., Fan E. Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA. 2012;307:2526–2533. - PubMed
    1. Seok Kim J., Young Lee J., Won Yang J., Hwa Lee K., Effenberger M., Szpirt W. Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics. 2021;11:316–329. - PMC - PubMed
    1. Yavuz S., Ünal S. Antiviral treatment of COVID-19. Turk. J. Med. Sci. 2020;50:611–619. - PMC - PubMed
    1. Ghasemnejad-Berenji M., Pashapour S. Favipiravir and COVID-19: A Simplified Summary. Drug Res. 2021;71:166–170. doi: 10.1055/a-1296-7935. - DOI - PMC - PubMed
    1. Echeverría-Esnal D., Martin-Ontiyuelo C., Navarrete-Rouco E., De-Antonio Cuscó M., Ferrández O. Azithromycin in the treatment of COVID-19: A review. Expert. Rev. Anti-Infect Ther. 2021;19:147–163. doi: 10.1080/14787210.2020.1813024. - DOI - PubMed