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Plasmapheresis reduces cytokine and immune cell levels in COVID-19 patients with acute respiratory distress syndrome (ARDS).
Hashemian, Seyed MohammadReza; Shafigh, Navid; Afzal, Golnaz; Jamaati, Hamidreza; Tabarsi, Payam; Marjani, Majid; Malekmohammad, Majid; Mortazavi, Seyed Mehdi; Khoundabi, Batoul; Mansouri, Davood; Moniri, Afshin; Hajifathali, Abbas; Roshandel, Elham; Mortaz, Esmaeil; Adcock, Ian M.
  • Hashemian SM; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Shafigh N; Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Afzal G; Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Jamaati H; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Tabarsi P; Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Marjani M; Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Malekmohammad M; Tracheal Diseases Research Center (TDRC), NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Mortazavi SM; Department of Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Khoundabi B; Research Center For Health Management in Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.
  • Mansouri D; Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Moniri A; Virology Research Center (VRC), NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Hajifathali A; Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Roshandel E; Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Mortaz E; Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: emortaz@gmail.com.
  • Adcock IM; Cell and Molecular Biology Group, Airways Disease Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK; Priority Research Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
Pulmonology ; 27(6): 486-492, 2021.
Article in English | MEDLINE | ID: covidwho-957366
Semantic information from SemMedBD (by NLM)
1. Plasmapheresis TREATS Respiratory Distress Syndrom
Subject
Plasmapheresis
Predicate
TREATS
Object
Respiratory Distress Syndrom
2. Plasmapheresis TREATS COVID-19
Subject
Plasmapheresis
Predicate
TREATS
Object
COVID-19
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Respiratory Distress Syndrom PROCESS_OF C0030705
Subject
Respiratory Distress Syndrom
Predicate
PROCESS_OF
Object
C0030705
5. Plasmapheresis TREATS Patients
Subject
Plasmapheresis
Predicate
TREATS
Object
Patients
6. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
7. Plasmapheresis AFFECTS Inflammation
Subject
Plasmapheresis
Predicate
AFFECTS
Object
Inflammation
8. Hospitals LOCATION_OF Study
Subject
Hospitals
Predicate
LOCATION_OF
Object
Study
9. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
10. Invasive mechanical ventilation NOS NEG_TREATS COVID-19
Subject
Invasive mechanical ventilation NOS
Predicate
NEG_TREATS
Object
COVID-19
11. Immune response PROCESS_OF Patients
Subject
Immune response
Predicate
PROCESS_OF
Object
Patients
12. Plasmapheresis TREATS Respiratory Distress Syndrome, Adult
Subject
Plasmapheresis
Predicate
TREATS
Object
Respiratory Distress Syndrome, Adult
13. Plasmapheresis TREATS COVID-19
Subject
Plasmapheresis
Predicate
TREATS
Object
COVID-19
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. Respiratory Distress Syndrome, Adult PROCESS_OF Patients
Subject
Respiratory Distress Syndrome, Adult
Predicate
PROCESS_OF
Object
Patients
16. Plasmapheresis TREATS Patients
Subject
Plasmapheresis
Predicate
TREATS
Object
Patients
17. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
18. Plasmapheresis AFFECTS Inflammation
Subject
Plasmapheresis
Predicate
AFFECTS
Object
Inflammation
19. Hospitals LOCATION_OF Study
Subject
Hospitals
Predicate
LOCATION_OF
Object
Study
20. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
21. Invasive mechanical ventilation NOS NEG_TREATS COVID-19
Subject
Invasive mechanical ventilation NOS
Predicate
NEG_TREATS
Object
COVID-19
22. Immune response PROCESS_OF Patients
Subject
Immune response
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

In December 2019, pneumonia associated with a novel coronavirus (COVID-19) was reported in Wuhan, China. Acute respiratory distress syndrome (ARDS) is the most frequently observed complication in COVID-19 patients with high mortality rates. OBJECTIVE OF STUDY To observe the clinical effect of plasmapheresis on excessive inflammatory reaction and immune features in patients with severe COVID-19 at risk of ARDS. MATERIALS AND

METHODS:

In this single-center study, we included 15 confirmed cases of COVID-19 at Masih Daneshvari Hospital, in March 2020 in Tehran, Iran. COVID-19 cases were confirmed by RT-PCR and CT imaging according to WHO guidelines. Plasmapheresis was performed to alleviate cytokine-induced ARDS. The improvement in oxygen delivery (PaO2/FiO2), total number of T cells, liver enzymes, acute reaction proteins, TNF-α and IL-6 levels were evaluated.

RESULTS:

Inflammatory cytokine levels (TNF-α, IL-6), and acute phase reaction proteins including ferritin and CRP were high before plasmapheresis. After plasmapheresis, the levels of PaO2/FiO2, acute phase reactants, inflammatory mediators, liver enzymes and bilirubin were significantly reduced within a week (p < 0.05). In contrast, although the number of T helper cells decreased immediately after plasmapheresis, they rose to above baseline levels after 1 week. Nine out of fifteen patients on non-invasive positive-pressure ventilation (NIPPV) survived whilst the six patients undergoing invasive mechanical ventilation (IMV) died.

CONCLUSION:

Our data suggests that plasmapheresis improves systemic cytokine and immune responses in patients with severe COVID-19 who do not undergo IMV. Further controlled studies are required to explore the efficacy of plasmapheresis treatment in patients with COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Plasmapheresis / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Country/Region as subject: Asia Language: English Journal: Pulmonology Year: 2021 Document Type: Article Affiliation country: J.pulmoe.2020.10.017

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Plasmapheresis / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Country/Region as subject: Asia Language: English Journal: Pulmonology Year: 2021 Document Type: Article Affiliation country: J.pulmoe.2020.10.017