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Transfus Apher Sci ; 60(6): 103237, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1366698


SARS-CoV-2 attaches to the angiotensin-converting enzyme 2 (ACE-2) receptor on human cells. The virus causes hypercytokinemia, capillary leak, pulmonary edema, acute respiratory distress syndrome, acute cardiac injury, and leads to death. Mesenchymal stem cells (MSCs) are ACE-2 negative cells; therefore, can escape from SARS-CoV-2. MSCs prevent hypercytokinemia and help the resolution of the pulmonary edema and other damages occurred during the course of COVID-19. In addition, MSCs enhance the regeneration of the lung and other tissues affected by SARS-CoV-2. The case series reported beneficial effect of MSCs in COVID-19 treatment. However, there are some concerns about the safety of MSCs, particularly referring to the increased risk of disseminated intravascular coagulation, and thromboembolism due to the expression of TF/CD142. Prospective, randomized, large scale studies are needed to reveal the optimum dose, administration way, time, efficacy, and safety of MSCs in the COVID-19 treatment.

COVID-19 , Lung/physiology , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/metabolism , Regeneration , SARS-CoV-2/metabolism , COVID-19/blood , COVID-19/epidemiology , COVID-19/therapy , Disseminated Intravascular Coagulation/blood , Disseminated Intravascular Coagulation/etiology , Humans , Peptidyl-Dipeptidase A/metabolism , Prospective Studies , Risk Factors , Thromboembolism/blood , Thromboembolism/etiology , Thromboplastin/biosynthesis
J Clin Apher ; 35(4): 367-373, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-680259


There are currently no licensed vaccines or therapeutics for COVID-19. Anti-SARS CoV-2 antibody-containing plasmas, obtained from the recovered individuals who had confirmed COVID-19, have been started to be collected using apheresis devices and stored in blood banks in some countries in order to administer to the patients with COVID-19 for reducing the need of intensive care and the mortality rates. Therefore, in this review, we aim to point out some important issues related to convalescent plasma (CP) and its use in COVID-19. CP may be an adjunctive treatment option to the anti-viral therapy. The protective effect of CP may continue for weeks and months. After the assessment of the donor, 200-600 mL plasma can be collected with apheresis devices. The donation interval may vary between countries. Even though limited published studies are not prospective or randomized, until the development of vaccines or therapeutics, CP seems to be a safe and probably effective treatment for critically ill patients with COVID-19. It could also be used for prophylactic purposes but the safety and effectiveness of this approach should be tested in randomized prospective clinical trials.

Betacoronavirus , Coronavirus Infections/therapy , Pandemics , Pneumonia, Viral/therapy , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Blood Donors , COVID-19 , Combined Modality Therapy , Coronavirus Infections/drug therapy , Coronavirus Infections/immunology , Coronavirus Infections/prevention & control , Donor Selection/standards , Female , Humans , Immunization, Passive , Male , Pandemics/prevention & control , Plasmapheresis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/immunology , Pneumonia, Viral/prevention & control , SARS-CoV-2
Transfus Apher Sci ; 59(4): 102855, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-613576


The activation of the innate and adaptive immune systems by SARS-CoV-2 causes the release of several inflammatory cytokines, including IL-6. The inflammatory hypercytokinemia causes immunopathological changes in the lungs including vascular leakage, and alveolar edema. As a result of these changes in the lungs, hypoxia and acute respiratory distress syndrome occur in patients with COVID-19. Even though there are clinical trials on the development of therapeutics and vaccines, there are currently no licensed vaccines or therapeutics for COVID-19. Pharmacological approaches have shown poor results in sepsis-like syndromes caused by the hypercytokinemia. Suppressing the cytokine storm is an important way to prevent the organ damage in patients with COVID-19. Extracorporeal blood purification could be proposed as an adjunctive therapy for sepsis, aiming to control the associated dysregulation of the immune system, which is known to protect organ functions. Several extracorporeal blood purification therapies are now available, and most of them target endotoxins and/or the cytokines and aim improving the immune response. For this purpose, plasmapheresis and immunoadsorption may be an important adjunctive treatment option to manage the complications caused by cytokine storm in critically ill patients with COVID-19.

Betacoronavirus , Coronavirus Infections/therapy , Extracorporeal Circulation , Pandemics , Plasmapheresis , Pneumonia, Viral/therapy , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Cytokine Release Syndrome/blood , Cytokine Release Syndrome/etiology , Cytokine Release Syndrome/prevention & control , Cytokines/blood , Humans , Plasma Exchange , Plasmapheresis/methods , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Respiratory Distress Syndrome/etiology , SARS-CoV-2