Therapeutic Plasma Exchange in Adult Patients with COVID-19 and Severe Pneumonia: Single Center Experience of Eighty Patients

Bilal Aygun; Funda Pepedil Tanrikulu; Mahmut Bakır Koyuncu

Makale detayları

Therapeutic Plasma Exchange in Adult Patients with COVID-19 and Severe Pneumonia: Single Center Experience of Eighty Patients

Yazarlar:

Bilal Aygun | Funda Pepedil Tanrikulu | Mahmut Bakır Koyuncu

Yayıncı:

Duzce University

Ana Başlıklar:

Clinical Sciences

Dergi:

Duzce Medical Journal Vol.25 Issue 1, pp.15-20

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284105

pISSN:

1307-671X

Anahtar kelimeler:

Özet:

 Aim: Therapeutic plasma exchange TPE is a frequently discussed treatment modality in severe coronavirus disease 2019 COVID-19 patients. It requires an apheresis device and experienced personnel for the application. In this study, we aimed to reveal the characteristics and clinical outcomes of adult patients with COVID-19 who experienced TPE. Material and Methods: Adult patients who had undergone TPE in our apheresis unit were retrospectively analyzed and COVID-19-positive cases were included in the study. All the medical information about the cases was obtained from the electronic database and technical details of the procedures were gathered from apheresis unit records. Results: A total of 80 patients with a median age of 60 19-85 years were included in the study. Severe pneumonia was present in 98.8 n79 of the cases. More than three-quarters of the patients had lymphopenia, critically elevated C-reactive protein CRP, and D-dimer, and 41.0 n32 had high ferritin. The median length of stay in the intensive care unit was 26 5-124 days. The mortality rate observed on the 14th and 28th days following the TPE procedure was 51.3 n41 and 75.0 n60, respectively. High ferritin level, multiple organ failure MOF, and intubation were parameters found to be associated with mortality in the multivariate analysis. Conclusion: The mortality rate observed in patients with COVID-19 who underwent TPE in our study was similar to the cases in the literature without the procedure, while it has been shown that high ferritin levels, intubation, and the presence of MOF increase the risk of mortality.

 Aim: Therapeutic plasma exchange TPE is a frequently discussed treatment modality in severe coronavirus disease 2019 COVID-19 patients. It requires an apheresis device and experienced personnel for the application. In this study, we aimed to reveal the characteristics and clinical outcomes of adult patients with COVID-19 who experienced TPE. Material and Methods: Adult patients who had undergone TPE in our apheresis unit were retrospectively analyzed and COVID-19-positive cases were included in the study. All the medical information about the cases was obtained from the electronic database and technical details of the procedures were gathered from apheresis unit records. Results: A total of 80 patients with a median age of 60 19-85 years were included in the study. Severe pneumonia was present in 98.8 n79 of the cases. More than three-quarters of the patients had lymphopenia, critically elevated C-reactive protein CRP, and D-dimer, and 41.0 n32 had high ferritin. The median length of stay in the intensive care unit was 26 5-124 days. The mortality rate observed on the 14th and 28th days following the TPE procedure was 51.3 n41 and 75.0 n60, respectively. High ferritin level, multiple organ failure MOF, and intubation were parameters found to be associated with mortality in the multivariate analysis. Conclusion: The mortality rate observed in patients with COVID-19 who underwent TPE in our study was similar to the cases in the literature without the procedure, while it has been shown that high ferritin levels, intubation, and the presence of MOF increase the risk of mortality.

 Aim: Therapeutic plasma exchange TPE is a frequently discussed treatment modality in severe coronavirus disease 2019 COVID-19 patients. It requires an apheresis device and experienced personnel for the application. In this study, we aimed to reveal the characteristics and clinical outcomes of adult patients with COVID-19 who experienced TPE. Material and Methods: Adult patients who had undergone TPE in our apheresis unit were retrospectively analyzed and COVID-19-positive cases were included in the study. All the medical information about the cases was obtained from the electronic database and technical details of the procedures were gathered from apheresis unit records. Results: A total of 80 patients with a median age of 60 19-85 years were included in the study. Severe pneumonia was present in 98.8 n79 of the cases. More than three-quarters of the patients had lymphopenia, critically elevated C-reactive protein CRP, and D-dimer, and 41.0 n32 had high ferritin. The median length of stay in the intensive care unit was 26 5-124 days. The mortality rate observed on the 14th and 28th days following the TPE procedure was 51.3 n41 and 75.0 n60, respectively. High ferritin level, multiple organ failure MOF, and intubation were parameters found to be associated with mortality in the multivariate analysis. Conclusion: The mortality rate observed in patients with COVID-19 who underwent TPE in our study was similar to the cases in the literature without the procedure, while it has been shown that high ferritin levels, intubation, and the presence of MOF increase the risk of mortality.

 Amaç: Terapötik plazma değişimi TPD, ağır düzey koronavirüs hastalığı 2019 coronavirus disease 2019, COVID-19 hastalarında sıklıkla tartışılmakta olan bir tedavi şeklidir. Uygulanması için deneyimli personele ve aferez cihazına gereksinim vardır. Bu çalışmada, TPD uygulanmış olan erişkin COVID-19 hastalarının özellikleri ve klinik sonlanımlarının ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Aferez ünitemizde TPD uygulanmış olan erişkin hastalar geriye dönük olarak incelenmiş ve COVID-19 pozitif olan vakalar bu çalışmaya dahil edilmiştir. Olgulara ait olan tüm tıbbi bilgiler elektronik veri tabanından alınmış ve aferez işlemlerine ait teknik detaylar ise aferez ünitesi kayıtlarından elde edilmiştir. Bulgular: Bu çalışmaya, ortanca yaşı 60 19-85 yıl olan toplam 80 hasta dahil edildi. Olguların 98,8 n79inde ağır pnömoni varlığı söz konusu idi. Tüm olguların dörtte üçünden daha fazlasında lenfopeni, kritik düzeyde C-reaktif protein CRP ve D-dimer yüksekliği ile 41,0 n32inde ise ferritin yüksekliği mevcuttu. Yoğun bakım ünitesinde ortanca kalış süresi 26 5-124 gündü. TPD işlemini takip eden 14. ve 28. günlerde gözlenen mortalite oranları sırasıyla 51,3 n41 ve 75,0 n60 idi. Çok değişkenli analizlerde ferritin yüksekliği, çoklu organ yetmezliği multiple organ failure, MOF varlığı ve entübasyon ihtiyacı mortalite ile ilişkili olarak bulundu. Sonuç: Araştırmamızda TPD uygulanan COVID-19lu hastalar için gözlenen mortalite oranı literatürdeki işlem yapılmayan olgularla benzer bulunurken, bu hastalarda ferritin yüksekliği, entübasyon ve MOF varlığının mortalite riskini artırdığı gösterilmiştir.

Makale detayları

Therapeutic Plasma Exchange in Adult Patients with COVID-19 and Severe Pneumonia: Single Center Experience of Eighty Patients

Yazarlar:

Bilal Aygun | Funda Pepedil Tanrikulu | Mahmut Bakır Koyuncu

Yayıncı:

Duzce University

Ana Başlıklar:

Clinical Sciences

Dergi:

Duzce Medical Journal Vol.25 Issue 1, pp.15-20

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284105

pISSN:

1307-671X

theurapeutic plasma exchange

pneumonia

COVID-19

terapötik plazma değişimi

pnömoni

COVID-19

Sayı

Makale detayları

Therapeutic Plasma Exchange in Adult Patients with COVID-19 and Severe Pneumonia: Single Center Experience of Eighty Patients

Yazarlar: Bilal Aygun | Funda Pepedil Tanrikulu | Mahmut Bakır Koyuncu

Yayıncı: Duzce University

Ana Başlıklar: Clinical Sciences

Dergi: Duzce Medical Journal Vol.25 Issue 1, pp.15-20

Belge Tipi: Makale

Yayın Tarihi: 4/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001284105

pISSN: 1307-671X

theurapeutic plasma exchange

pneumonia

COVID-19

terapötik plazma değişimi

pnömoni

COVID-19

Sayı

Yazarlar:

Bilal Aygun | Funda Pepedil Tanrikulu | Mahmut Bakır Koyuncu

Yayıncı:

Duzce University

Ana Başlıklar:

Clinical Sciences

Dergi:

Duzce Medical Journal Vol.25 Issue 1, pp.15-20

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284105

pISSN:

1307-671X