Zaid Ikram, Essaad Ounci, El Aidouni Ghizlane, Aabdi Mohammed, Berrichi Samia, Taouihar Salma, Marbouh Manal, Bkiyer Houssam, Abda Naima, Housni Brahim
Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.
Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.
Ann Med Surg (Lond). 2021 Nov;71:102920. doi: 10.1016/j.amsu.2021.102920. Epub 2021 Oct 7.
COVID 19 pneumonia can lead to an inappropriate inflammatory response, and can be complicated by acute respiratory distress syndrome, multivisceral failure with a high mortality rate.
To observe the effect of therapeutic plasma exchange on the excessive inflammatory response.
In this study, we included 7 confirmed cases of COVID-19 in the intensive care unit (ICU) department of the university hospital of Oujda. COVID-19 cases were confirmed by RT PCR (reverse transcription-polymerase chain) and CT (computerized tomography) imaging according to WHO guidelines. Therapeutic plasma exchange was performed decrease cytokine storm-induced ARDS (Acute respiratory distress syndrome). Inflammation marker assays were performed before and after therapeutic plasma exchange to assess its efficacy.
Levels of inflammatory cytokines (IL-6) and acute phase response proteins, including ferritin and CRP, were elevated before therapeutic plasma exchange.After therapeutic plasma exchange, levels of acute phase reactants, inflammatory mediators, were significantly reduced (p < 0.05).
Our data suggest that therapeutic plasma exchange reduces the inflammatory response in patients with severe COVID-19 not undergoing mechanical ventilation. Further studies are needed to explore the efficacy of therapeutic plasma exchange in patients with COVID-19.
新型冠状病毒肺炎可导致不适当的炎症反应,并可能并发急性呼吸窘迫综合征、多脏器功能衰竭,死亡率很高。
观察治疗性血浆置换对过度炎症反应的影响。
在本研究中,我们纳入了奥贾达大学医院重症监护病房(ICU)的7例确诊新型冠状病毒肺炎病例。根据世界卫生组织的指南,通过逆转录聚合酶链反应(RT-PCR)和计算机断层扫描(CT)成像确诊新型冠状病毒肺炎病例。进行治疗性血浆置换以减少细胞因子风暴诱导的急性呼吸窘迫综合征(ARDS)。在治疗性血浆置换前后进行炎症标志物检测以评估其疗效。
治疗性血浆置换前,炎症细胞因子(IL-6)和急性期反应蛋白(包括铁蛋白和CRP)水平升高。治疗性血浆置换后,急性期反应物、炎症介质水平显著降低(p<0.05)。
我们的数据表明,治疗性血浆置换可降低未接受机械通气的重症新型冠状病毒肺炎患者的炎症反应。需要进一步研究以探索治疗性血浆置换对新型冠状病毒肺炎患者的疗效。