Efficiency and safety of plasma exchange in the treatment of severe COVID-19

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OBJECTIVE

To study an efficacy and safety of therapeutic plasma exchange in the treatment of COVID-19.

MATERIAL AND METHODS

Efficacy and safety of plasma exchange in severe COVID-19 were retrospectively analyzed. Plasma exchange was performed within 24 hours after admission to ICU. Circulating plasma volume (70-150%) was replaced with donor fresh frozen plasma, CovRec plasma ≤300 ml and balanced crystalloid solutions ≤800 ml. Mean volume of exchange was 3000 ml (min 2000 ml, max 4000 ml). We analyzed mortality and need for mechanical ventilation in patients after plasma exchange in addition to standard therapy (main group) and in the control group (standard therapy alone).

RESULTS

Mortality in the main group was 16.67% (n=5), in the control group — 57.41% (n=31) (p=0.001).

CONCLUSION

Plasma exchange is an effective and safe method significantly reducing mortality in patients with severe COVID-19. These data are confirmed by laboratory data. A multiple-center study of efficacy and safety of plasma exchange in the treatment of severe COVID-19 is needed.

Keywords:

plasma exchange

COVID-19

cytokine storm

endotheliopathy

ARDS

coagulopathy

Authors:

Ochkin S.S.

Burnazyan Federal Medical Biophysical Center of the FMBA of Russia

Samoylov A.S.

State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Udalov Yu.D.

State Research Center of the Russian Federation — Burnazyan Federal Medical Biophysical Center

Kruglyakov N.M.

State Research Center of the Russian Federation — Burnazyan Federal Medical Biophysical Center

Bagzhanov G.I.

State Research Center of the Russian Federation — Burnazyan Federal Medical Biophysical Center

Received:

15.11.2020

Accepted:

17.12.2020

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