tetano
Editor, Senior Moderator
J Inflamm Res
. 2022 Feb 3;15:715-722.
doi: 10.2147/JIR.S344028. eCollection 2022.
Therapeutic Plasma Exchanges in Combination with High-Dose Steroid-Induced Immunosuppression as an Ultima Ratio Therapy in Severe Coronavirus Disease 2019 (COVID-19): A Case-Series Report
Agata Janikowska[SUP] 1 [/SUP], Jens Soukup[SUP] 2 [/SUP], Rainer U Pliquett[SUP] 1 [/SUP], Rabah Abdel-Rahim[SUP] 1 [/SUP]
Affiliations
Abstract
We present 2 cases of severe Covid-19 with comorbidities (arterial hypertension, obesity, diabetes mellitus) treated with membrane-based therapeutic plasma exchanges in combination with a short-term high-dose immunosuppressive therapy. The therapy has been initiated in an attempt to alleviate the prevalent cytokine storm and to prevent intubation and invasive mechanical ventilation, when a long-term nasal oxygen therapy with a maximum flow rate of 8L/min was insufficient to achieve an adequate oxygenation. Even though patient 2 had to be intubated after the 4th cycle of plasmapheresis due to the exhaustion of the respiratory muscles and the subsequent acquired sepsis with a microbiological evidence of a mixed bacterial-fungal infection, both patients showed a good response to treatment, including improvement of laboratory and radiological findings. To our knowledge, this combination of therapeutic plasma exchange with a high-dose steroid therapy has not been reported previously.
Keywords: Covid-19; cytokine storm; immunosuppression; plasmapheresis.
. 2022 Feb 3;15:715-722.
doi: 10.2147/JIR.S344028. eCollection 2022.
Therapeutic Plasma Exchanges in Combination with High-Dose Steroid-Induced Immunosuppression as an Ultima Ratio Therapy in Severe Coronavirus Disease 2019 (COVID-19): A Case-Series Report
Agata Janikowska[SUP] 1 [/SUP], Jens Soukup[SUP] 2 [/SUP], Rainer U Pliquett[SUP] 1 [/SUP], Rabah Abdel-Rahim[SUP] 1 [/SUP]
Affiliations
- PMID: 35140501
- PMCID: PMC8820755
- DOI: 10.2147/JIR.S344028
Abstract
We present 2 cases of severe Covid-19 with comorbidities (arterial hypertension, obesity, diabetes mellitus) treated with membrane-based therapeutic plasma exchanges in combination with a short-term high-dose immunosuppressive therapy. The therapy has been initiated in an attempt to alleviate the prevalent cytokine storm and to prevent intubation and invasive mechanical ventilation, when a long-term nasal oxygen therapy with a maximum flow rate of 8L/min was insufficient to achieve an adequate oxygenation. Even though patient 2 had to be intubated after the 4th cycle of plasmapheresis due to the exhaustion of the respiratory muscles and the subsequent acquired sepsis with a microbiological evidence of a mixed bacterial-fungal infection, both patients showed a good response to treatment, including improvement of laboratory and radiological findings. To our knowledge, this combination of therapeutic plasma exchange with a high-dose steroid therapy has not been reported previously.
Keywords: Covid-19; cytokine storm; immunosuppression; plasmapheresis.