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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...

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Autores principales: Keith, Philip, Day, Matthew, Choe, Carol, Perkins, Linda, Moyer, Lou, Hays, Erin, French, Marshall, Hewitt, Kristi, Gravel, Gretchen, Guffey, Amanda, Scott, L Keith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
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.
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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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