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The successful use of therapeutic plasma exchange for severe COVID-19 acute respiratory distress syndrome with multiple organ failure
The COVID-19 pandemic has brought about an urgent need for effective treatment, while conserving vital resources such as intensive care unit beds and ventilators. Antivirals, convalescent plasma, and biologics have been used with mixed results. The profound “cytokine storm” induced endotheliopathy a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303771/ https://www.ncbi.nlm.nih.gov/pubmed/32595974 http://dx.doi.org/10.1177/2050313X20933473 |
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author | Keith, Philip Day, Matthew Choe, Carol Perkins, Linda Moyer, Lou Hays, Erin French, Marshall Hewitt, Kristi Gravel, Gretchen Guffey, Amanda Scott, L Keith |
author_facet | Keith, Philip Day, Matthew Choe, Carol Perkins, Linda Moyer, Lou Hays, Erin French, Marshall Hewitt, Kristi Gravel, Gretchen Guffey, Amanda Scott, L Keith |
author_sort | Keith, Philip |
collection | PubMed |
description | The COVID-19 pandemic has brought about an urgent need for effective treatment, while conserving vital resources such as intensive care unit beds and ventilators. Antivirals, convalescent plasma, and biologics have been used with mixed results. The profound “cytokine storm” induced endotheliopathy and microthrombotic disease in patients with COVID-19 may lead to acute respiratory distress syndrome, sepsis, and multi-organ failure. We present a case of SARS-COV2 pneumonia with septic shock and multi-organ failure that demonstrated significant clinical improvement after therapeutic plasma exchange. A 65-year-old female with multiple comorbidities presented with progressive dyspnea and dry cough. She was found to be COVID-19 positive with pneumonia, and developed progressive hypoxemia and shock requiring vasopressors, cardioversion, and non-invasive positive pressure ventilation. Given her worsening sepsis with multi-organ failure, she underwent therapeutic plasma exchange with rapid clinical improvement. Her case supports the theory that plasma exchange may help abate the “cytokine storm” induced endotheliopathy and microthrombosis associated with COVID-19. Further studies are needed to identify markers of this pathway and the potential role of plasma exchange in these critically ill patients. |
format | Online Article Text |
id | pubmed-7303771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-73037712020-06-26 The successful use of therapeutic plasma exchange for severe COVID-19 acute respiratory distress syndrome with multiple organ failure Keith, Philip Day, Matthew Choe, Carol Perkins, Linda Moyer, Lou Hays, Erin French, Marshall Hewitt, Kristi Gravel, Gretchen Guffey, Amanda Scott, L Keith SAGE Open Med Case Rep Case Report The COVID-19 pandemic has brought about an urgent need for effective treatment, while conserving vital resources such as intensive care unit beds and ventilators. Antivirals, convalescent plasma, and biologics have been used with mixed results. The profound “cytokine storm” induced endotheliopathy and microthrombotic disease in patients with COVID-19 may lead to acute respiratory distress syndrome, sepsis, and multi-organ failure. We present a case of SARS-COV2 pneumonia with septic shock and multi-organ failure that demonstrated significant clinical improvement after therapeutic plasma exchange. A 65-year-old female with multiple comorbidities presented with progressive dyspnea and dry cough. She was found to be COVID-19 positive with pneumonia, and developed progressive hypoxemia and shock requiring vasopressors, cardioversion, and non-invasive positive pressure ventilation. Given her worsening sepsis with multi-organ failure, she underwent therapeutic plasma exchange with rapid clinical improvement. Her case supports the theory that plasma exchange may help abate the “cytokine storm” induced endotheliopathy and microthrombosis associated with COVID-19. Further studies are needed to identify markers of this pathway and the potential role of plasma exchange in these critically ill patients. SAGE Publications 2020-06-18 /pmc/articles/PMC7303771/ /pubmed/32595974 http://dx.doi.org/10.1177/2050313X20933473 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Keith, Philip Day, Matthew Choe, Carol Perkins, Linda Moyer, Lou Hays, Erin French, Marshall Hewitt, Kristi Gravel, Gretchen Guffey, Amanda Scott, L Keith The successful use of therapeutic plasma exchange for severe COVID-19 acute respiratory distress syndrome with multiple organ failure |
title | The successful use of therapeutic plasma exchange for severe COVID-19
acute respiratory distress syndrome with multiple organ failure |
title_full | The successful use of therapeutic plasma exchange for severe COVID-19
acute respiratory distress syndrome with multiple organ failure |
title_fullStr | The successful use of therapeutic plasma exchange for severe COVID-19
acute respiratory distress syndrome with multiple organ failure |
title_full_unstemmed | The successful use of therapeutic plasma exchange for severe COVID-19
acute respiratory distress syndrome with multiple organ failure |
title_short | The successful use of therapeutic plasma exchange for severe COVID-19
acute respiratory distress syndrome with multiple organ failure |
title_sort | successful use of therapeutic plasma exchange for severe covid-19
acute respiratory distress syndrome with multiple organ failure |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303771/ https://www.ncbi.nlm.nih.gov/pubmed/32595974 http://dx.doi.org/10.1177/2050313X20933473 |
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