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Impact of plasmapheresis on severe COVID-19

The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and res...

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Autores principales: Fonseca-González, G., Alamilla-Sánchez, M., García-Macas, V., Herrera-Acevedo, J., Villalobos-Brito, M., Tapia-Rangel, E., Maldonado-Tapia, D., López-Mendoza, M., Cano-Cervantes, J. H., Orozco-Vázquez, J., Timarán-Montenegro, D., Cortés-Martínez, S., Escarela-Serrano, M., Muñoz-López, S., Montiel-López, L., Mondragón-Terán, P., Suárez-Cuenca, J. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812351/
https://www.ncbi.nlm.nih.gov/pubmed/36599875
http://dx.doi.org/10.1038/s41598-022-25930-8
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author Fonseca-González, G.
Alamilla-Sánchez, M.
García-Macas, V.
Herrera-Acevedo, J.
Villalobos-Brito, M.
Tapia-Rangel, E.
Maldonado-Tapia, D.
López-Mendoza, M.
Cano-Cervantes, J. H.
Orozco-Vázquez, J.
Timarán-Montenegro, D.
Cortés-Martínez, S.
Escarela-Serrano, M.
Muñoz-López, S.
Montiel-López, L.
Mondragón-Terán, P.
Suárez-Cuenca, J. A.
author_facet Fonseca-González, G.
Alamilla-Sánchez, M.
García-Macas, V.
Herrera-Acevedo, J.
Villalobos-Brito, M.
Tapia-Rangel, E.
Maldonado-Tapia, D.
López-Mendoza, M.
Cano-Cervantes, J. H.
Orozco-Vázquez, J.
Timarán-Montenegro, D.
Cortés-Martínez, S.
Escarela-Serrano, M.
Muñoz-López, S.
Montiel-López, L.
Mondragón-Terán, P.
Suárez-Cuenca, J. A.
author_sort Fonseca-González, G.
collection PubMed
description The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071–0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO(2)/FiO(2) indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events.
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spelling pubmed-98123512023-01-04 Impact of plasmapheresis on severe COVID-19 Fonseca-González, G. Alamilla-Sánchez, M. García-Macas, V. Herrera-Acevedo, J. Villalobos-Brito, M. Tapia-Rangel, E. Maldonado-Tapia, D. López-Mendoza, M. Cano-Cervantes, J. H. Orozco-Vázquez, J. Timarán-Montenegro, D. Cortés-Martínez, S. Escarela-Serrano, M. Muñoz-López, S. Montiel-López, L. Mondragón-Terán, P. Suárez-Cuenca, J. A. Sci Rep Article The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071–0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO(2)/FiO(2) indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events. Nature Publishing Group UK 2023-01-04 /pmc/articles/PMC9812351/ /pubmed/36599875 http://dx.doi.org/10.1038/s41598-022-25930-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Fonseca-González, G.
Alamilla-Sánchez, M.
García-Macas, V.
Herrera-Acevedo, J.
Villalobos-Brito, M.
Tapia-Rangel, E.
Maldonado-Tapia, D.
López-Mendoza, M.
Cano-Cervantes, J. H.
Orozco-Vázquez, J.
Timarán-Montenegro, D.
Cortés-Martínez, S.
Escarela-Serrano, M.
Muñoz-López, S.
Montiel-López, L.
Mondragón-Terán, P.
Suárez-Cuenca, J. A.
Impact of plasmapheresis on severe COVID-19
title Impact of plasmapheresis on severe COVID-19
title_full Impact of plasmapheresis on severe COVID-19
title_fullStr Impact of plasmapheresis on severe COVID-19
title_full_unstemmed Impact of plasmapheresis on severe COVID-19
title_short Impact of plasmapheresis on severe COVID-19
title_sort impact of plasmapheresis on severe covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812351/
https://www.ncbi.nlm.nih.gov/pubmed/36599875
http://dx.doi.org/10.1038/s41598-022-25930-8
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