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Therapeutic plasma exchange for COVID-19-associated hyperviscosity
Alexander D Truong1, Sara C Auld1,2, Nicholas A Barker3
1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory Critical Care Center, Emory University School of Medicine, Atlanta, Georgia, USA.
Transfusion
|November 24, 2020
Summary
Therapeutic plasma exchange (TPE) effectively reduced blood hyperviscosity in critically ill COVID-19 patients. This intervention showed promise in improving clinical status for some patients with severe COVID-19-associated hyperviscosity.
Area of Science:
- Hematology
- Critical Care Medicine
- Infectious Diseases
Background:
- COVID-19 is associated with blood hyperviscosity, increasing thrombosis risk and disease severity.
- Hyperviscosity may contribute to endothelial damage and multiorgan failure in COVID-19 patients.
- Therapeutic plasma exchange (TPE) is explored as a potential treatment to reduce viscosity and improve outcomes.
Observation:
- Six critically ill COVID-19 patients with significantly elevated plasma viscosity (2.6-4.2 cP) underwent 2-3 daily TPE treatments.
- TPE was administered to address COVID-19-associated hyperviscosity.
Findings:
- TPE successfully decreased plasma viscosity in all six patients, normalizing levels (median from 3.75 cP to 1.6 cP).
- The treatment also reduced fibrinogen, D-dimer, and CRP levels in most patients.
- Four out of six patients showed significant clinical improvement following TPE, though two of the sickest patients did not survive.
Implications:
- TPE demonstrates utility in rapidly correcting hyperviscosity in COVID-19 patients.
- Further large randomized trials are necessary to confirm the clinical benefits of TPE for COVID-19 outcomes.
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