Skip to main content Skip to main navigation menu Skip to site footer

Efficacy of therapeutic plasma exchange and convalescent plasma therapy in moderate-to-severe COVID-19 patients

  • Reviono ,
  • Faizal Muhammad ,
  • Ken Zuraida Maharestri ,
  • Ihsan Hanif ,
  • Coana Sukmagautama ,
  • Hendrastutik Apriningsih ,
  • Arif Zuhal Amin Hananto ,
  • Harsini ,

Abstract

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health catastrophe since its first reported cases in late December 2019. Critically ill COVID-19 patients have been related to cytokine storms leading to acute respiratory distress syndrome and high mortality rates. Therapeutic plasma exchange (TPE) and convalescent plasma (CP) therapy improve clinically by removing inflammatory cytokines excess and using passive antibody-containing blood, respectively. This study aimed to evaluate TPE and CP treatment for moderate-to-severe COVID-19 infection.

Method: The patients were randomly divided into TPE group (n = 10), CP group (n = 11), and control group (n = 10). This 1-week quasi-experimental study with a pretest–post-test control group design was conducted in the Intensive Care Unit (ICU) of Dr. Moewardi General Hospital and Universitas Sebelas Maret (UNS) Hospital. The study comparison between groups included blood gas analysis profile (pH, base excess, PaCO2, PaO2, hematocrit, HCO3, total CO2, SaO2), FiO2, P/F ratio, COVID-19 severity, and D-dimer. The paired t-test was used to analyze every group's pretest–post-test mean difference. One-way ANOVA was performed to analyze the mean difference across the three groups. SPSS version 22.0 for Windows was used to perform statistical analyses.

Result: TPE and CP groups showed significant clinical-laboratory improvement than control (p > 0.05). Furthermore, high clinical-laboratory improvement tendency was observed in CP therapy than TPE.

Conclusion: The use of TPE and CP in moderate-to-severe COVID-19 patients has been related to improving clinical-laboratory outcomes.

References

  1. Sofi MS, Hamid A, Bhat SU. SARS-CoV-2: A critical review of its history, pathogenesis, transmission, diagnosis and treatment. Biosaf Heal [Internet]. 2020 Dec 1 [cited 2022 Jul 3];2(4):217. doi: 10.1016/J.BSHEAL.2020.11.002
  2. King PT, Londrigan SL. The 1918 influenza and COVID‐19 pandemics: The effect of age on outcomes. Respirology [Internet]. 2021 Sep 1 [cited 2022 Jul 3];26(9):840. doi: 10.1111/RESP.14109
  3. COVID-19 Coronavirus Pandemic - Worldometer [Internet]. [cited 2022 Jul 3]. doi: https://www.worldometers.info/coronavirus/
  4. Dhillon RA, Qamar MA, Gilani JA, Irfan O, Waqar U, Sajid MI, et al. The mystery of COVID-19 reinfections: A global systematic review and meta-analysis. Ann Med Surg [Internet]. 2021 Dec 1 [cited 2022 Jul 3];72:103130. doi: 10.1016/J.AMSU.2021.103130
  5. Darif D, Hammi I, Kihel A, El Idrissi Saik I, Guessous F, Akarid K. The pro-inflammatory cytokines in COVID-19 pathogenesis: What goes wrong? Microb Pathog [Internet]. 2021 Apr 1 [cited 2022 Jul 3];153:104799. doi: 10.1016/J.MICPATH.2021.104799
  6. Khamis F, Al-Zakwani I, Al Hashmi S, Al Dowaiki S, Al Bahrani M, Pandak N, et al. Therapeutic plasma exchange in adults with severe COVID-19 infection. Int J Infect Dis. 2020 October 1;99:214–8. doi: 10.1016/J.IJID.2020.06.064
  7. Keith P, Day M, Choe C, Perkins L, Moyer L, Hays E, et al. The successful use of therapeutic plasma exchange for severe COVID-19 acute respiratory distress syndrome with multiple organ failure. SAGE open Med case reports [Internet]. 2020 Jan [cited 2022 Jul 3];8:2050313X2093347. doi: 10.1177/2050313X20933473
  8. Altuntas F, Ata N, Yigenoglu TN, Bascı S, Dal MS, Korkmaz S, et al. Convalescent plasma therapy in patients with COVID-19. Transfus Apher Sci [Internet]. 2021 [cited 2022 Jul 3];60(1):102955. doi: 10.1016/J.TRANSCI.2020.102955
  9. Burhan E, Susanto AD, Nasution S, Ginanjar E, Pitoyo CW. Pedoman Tatalaksana COVID-19 Edisi 1 [Internet]. 1st ed. Burhan E, editor. Jakarta: PDPI, PERKI, PAPDI, PERDATIN, IDAI, IDI; 2020 [cited 2022 Jul 4]. 1–45 p. doi: https://www.papdi.or.id/pdfs/872/Versi%20Cetak%20Protokol%20Tatalaksana%20COVID-19-ok.pdf
  10. Hashemian SMR, Shafigh N, Afzal G, Jamaati H, Tabarsi P, Marjani M, et al. Plasmapheresis reduces cytokine and immune cell levels in COVID-19 patients with acute respiratory distress syndrome (ARDS). Pulmonology. 2021 Nov 1;27(6):486–92. doi: 10.1016/J.PULMOE.2020.10.017
  11. He R, Wang J, Wang Z, Liu Y, Xu H, Zhang X, et al. A possible dose-response equation: Viral load after plasma infusion in COVID-19 patients and anti-SARS-CoV-2 antibody titers in convalescent plasma. Transfus Med [Internet]. 2022 April 1 [cited 2022 July 8];32(2):162–7. doi: 10.1111/TME.12852
  12. Zhan H, Chen H, Liu C, Cheng L, Yan S, Li H, et al. Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression. Clin Appl Thromb Hemost [Internet]. 2021 [cited 2022 July 8];27. doi: 10.1177/10760296211010976
  13. Beraud M, Hashami S Al, Lozano M, Bah A, Keith P. Role of therapeutic plasma exchange in the management of COVID-19-induced cytokine storm syndrome. Transfus Apher Sci [Internet]. 2022 [cited 2022 July 8]; doi: 10.1016/J.TRANSCI.2022.103433
  14. Franchini M, Glingani C, Liumbruno GM. Potential mechanisms of action of convalescent plasma in COVID-19. Diagnosis [Internet]. 2021 Nov 1 [cited 2022 Jul 8];8(4):413–20. doi: 10.1515/DX-2020-0161/ASSET/GRAPHIC/J_DX-2020-0161_FIG_001.JPG
  15. Lanza F, Seghatchian J. Reflection on passive immunotherapy in those who need most: some novel strategic arguments for obtaining safer therapeutic plasma or autologous antibodies from recovered COVID-19 infected patients. Br J Haematol [Internet]. 2020 July 1 [cited 2022 July 8];190(1):e27–9. doi: 10.1111/BJH.16814
  16. Erkurt MA, Sarici A, Berber İ, Kuku İ, Kaya E, Özgül M. Life-saving effect of convalescent plasma treatment in covid-19 disease: Clinical trial from eastern Anatolia. Transfus Apher Sci [Internet]. 2020 October 1 [cited 2022 July 8];59(5). doi: 10.1016/J.TRANSCI.2020.102867
  17. Focosi D, Anderson AO, Tang JW, Tuccori M. Convalescent Plasma Therapy for COVID-19: State of the Art. Clin Microbiol Rev [Internet]. 2020 October 1 [cited 2022 July 8];33(4):1–17. doi: 10.1128/CMR.00072-20
  18. Yang XH, Sun RH, Zhao MY, Chen EZ, Liu J, Wang HL, et al. Expert recommendations on blood purification treatment protocol for patients with severe COVID-19. Chronic Dis Transl Med [Internet]. 2020 June 1 [cited 2022 July 8];6(2):106–14. doi: 10.1016/J.CDTM.2020.04.002
  19. Qin J, Wang G, Han D. Benefits of plasma exchange on mortality in patients with COVID-19: a systematic review and meta-analysis. Int J Infect Dis [Internet]. 2022 Sep [cited 2022 July 8];122:332–6. doi: 10.1016/J.IJID.2022.06.014
  20. Sarkar S, Soni KD, Khanna P. Convalescent plasma is a clutch at straws in COVID-19 management! A systematic review and meta-analysis. J Med Virol [Internet]. 2021 February 1 [cited 2022 July 8];93(2):1111–8. doi: 10.1002/JMV.26408
  21. Piechotta V, Iannizzi C, Chai KL, Valk SJ, Kimber C, Dorando E, et al. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev [Internet]. 2021 May 20 [cited 2022 July 8];2021(5). doi: 10.1002/14651858.CD013600.PUB4/MEDIA/CDSR/CD013600/IMAGE_N/NCD013600-CMP-005.01.SVG
  22. Santosa, D., Sofro, M. A. U., Retnaningsih, R., Pangarsa, E. A., Setiawan, B., Farhanah, N., et al. Convalescent plasma as an adjunctive treatment for severe and critically ill COVID-19. Bali Medical Journal. 2021 [cited 2022 July 8];10(3):851–859. doi: https://doi.org/10.15562/bmj.v10i3.2590

How to Cite

Reviono, Muhammad, F., Maharestri, K. Z., Hanif, I., Sukmagautama, C., Apriningsih, H., Hananto, A. Z. A., & Harsini. (2022). Efficacy of therapeutic plasma exchange and convalescent plasma therapy in moderate-to-severe COVID-19 patients. Bali Medical Journal, 11(3), 1369–1374. https://doi.org/10.15562/bmj.v11i3.3493

HTML
20

Total
17

Share

Search Panel