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Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives

COVID-19 (coronavirus disease 2019), caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), emerged in Wuhan, China, and has spread worldwide, resulting in over 73 million cases and more than 1 600 000 deaths as of December 2020. Although the disease is asympto...

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Autores principales: Memish, Ziad A., Faqihi, Fahad, Alharthy, Abdulrahman, Alqahtani, Saleh A., Karakitsos, Dimitrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd and International Society of Antimicrobial Chemotherapy. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834644/
https://www.ncbi.nlm.nih.gov/pubmed/33370568
http://dx.doi.org/10.1016/j.ijantimicag.2020.106273
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author Memish, Ziad A.
Faqihi, Fahad
Alharthy, Abdulrahman
Alqahtani, Saleh A.
Karakitsos, Dimitrios
author_facet Memish, Ziad A.
Faqihi, Fahad
Alharthy, Abdulrahman
Alqahtani, Saleh A.
Karakitsos, Dimitrios
author_sort Memish, Ziad A.
collection PubMed
description COVID-19 (coronavirus disease 2019), caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), emerged in Wuhan, China, and has spread worldwide, resulting in over 73 million cases and more than 1 600 000 deaths as of December 2020. Although the disease is asymptomatic in most cases, some patients develop life-threatening disease characterised by acute respiratory distress syndrome, sepsis, multisystem organ failure (MSOF), extrapulmonary manifestations, thromboembolic disease and associated cytokine release syndrome. The rationale for applying therapeutic plasma exchange (TPE) early in the course of fulminant COVID-19 is the suppression of thromboinflammation and amelioration of microangiopathy, thus preventing the ensuing MSOF. In the course of complicated critical illness due to COVID-19, immune dysregulation may be as important as viral replication itself. Moreover, the natural course of SARS-CoV-2 infection remains obscure, as re-infections and/or recurrently positive real-time PCR results have been reported. Although concerns still exist regarding its potential immunosuppressive effects and safety, TPE shows promise in the management of life-threatening COVID-19 as documented by various pilot studies, which remain to be confirmed by future randomised controlled trials. However, current data suggest that TPE could be an adjunctive rescue therapy in complex COVID-19 critical illness.
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spelling pubmed-78346442021-01-26 Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives Memish, Ziad A. Faqihi, Fahad Alharthy, Abdulrahman Alqahtani, Saleh A. Karakitsos, Dimitrios Int J Antimicrob Agents Short Communication COVID-19 (coronavirus disease 2019), caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), emerged in Wuhan, China, and has spread worldwide, resulting in over 73 million cases and more than 1 600 000 deaths as of December 2020. Although the disease is asymptomatic in most cases, some patients develop life-threatening disease characterised by acute respiratory distress syndrome, sepsis, multisystem organ failure (MSOF), extrapulmonary manifestations, thromboembolic disease and associated cytokine release syndrome. The rationale for applying therapeutic plasma exchange (TPE) early in the course of fulminant COVID-19 is the suppression of thromboinflammation and amelioration of microangiopathy, thus preventing the ensuing MSOF. In the course of complicated critical illness due to COVID-19, immune dysregulation may be as important as viral replication itself. Moreover, the natural course of SARS-CoV-2 infection remains obscure, as re-infections and/or recurrently positive real-time PCR results have been reported. Although concerns still exist regarding its potential immunosuppressive effects and safety, TPE shows promise in the management of life-threatening COVID-19 as documented by various pilot studies, which remain to be confirmed by future randomised controlled trials. However, current data suggest that TPE could be an adjunctive rescue therapy in complex COVID-19 critical illness. Elsevier Ltd and International Society of Antimicrobial Chemotherapy. 2021-02 2020-12-25 /pmc/articles/PMC7834644/ /pubmed/33370568 http://dx.doi.org/10.1016/j.ijantimicag.2020.106273 Text en © 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Short Communication
Memish, Ziad A.
Faqihi, Fahad
Alharthy, Abdulrahman
Alqahtani, Saleh A.
Karakitsos, Dimitrios
Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title_full Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title_fullStr Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title_full_unstemmed Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title_short Plasma exchange in the treatment of complex COVID-19-related critical illness: controversies and perspectives
title_sort plasma exchange in the treatment of complex covid-19-related critical illness: controversies and perspectives
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834644/
https://www.ncbi.nlm.nih.gov/pubmed/33370568
http://dx.doi.org/10.1016/j.ijantimicag.2020.106273
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