Many patients with severe COVID-19 deteriorate rapidly when their immune systems become hyperactive, also known as cytokine storm. No effective treatments for cytokine storms in patients with COVID-19 have been identified, but researchers in China report that therapeutic plasma exchange (TPE) was an effective treatment in three male patients (aged 44, 55, and 64 years) with severe COVID-19; all three patients developed respiratory distress and were receiving high-flow oxygen. The patients had decreased lymphocytes and increased levels of C-reactive protein, neutrophil counts, lactate dehydrogenase, and interleukin-6. Within 6 days of receiving TPE with 3000 mL of fresh-frozen plasma as replacement, all patients had been weaned from receiving supplemental oxygen and the above mentioned lab values returned to normal. Within 10 days of receiving TPE, all three patients had negative SARS-CoV-2 nucleic acid tests and were discharged 18-25 days from symptom onset. Much more research is needed to confirm that TPE is beneficial for patients with severe COVID-19. Nevertheless, TPE has also been used to treat other respiratory diseases (pneumonia, H1N1 influenza virus) and other diseases with severe cytokine storms (sepsis and septic shock), and TPE may be beneficial for COVID-19.
Reference:
