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在治疗 SARS-CoV-2 方面,抢救性治疗性血浆置换的效果如何?

How effective is rescue therapeutic plasma exchange in treatment of SARS-Coronavirus-2?

机构信息

Hypertension, Nephrology, Dialysis & Transplantation, Opelika, Alabama, USA.

Department of Infectious Disease, East Alabama Medical Center, Opelika, Alabama, USA.

出版信息

Ther Apher Dial. 2023 Feb;27(1):170-176. doi: 10.1111/1744-9987.13862. Epub 2022 May 23.

DOI:10.1111/1744-9987.13862
PMID:35490343
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9348252/
Abstract

INTRODUCTION

After the FDA gave emergency approval for the use of therapeutic plasma exchange in treatment for SARS-Coronoavirus-2, we analyzed its efficacy in patients who had failed all other known therapies.

METHODS

This was a prospective observational study of 42 patients with SARS-Coronoavirus-2 who had failed conventional therapy and were treated with therapeutic plasma exchange. Pre- and postexchange clinical and laboratory parameters were monitored. The patients were then also compared with a group of 147 patients with SARS-Coronoavirus-2 who were referred for stage 3 acute renal failure and dialysis from SARS-Coronoavirus-2.

RESULTS

After therapeutic plasma exchange, there were significant improvements in some clinical parameters but mortality remained high; although better than the renal failure group (43.9% vs. 50.7%, p = 0.004).

CONCLUSION

SARS-CoV-2 patients who failed all other therapies had significant mortality with therapeutic plasma exchange; however, their survival was better than SARS-CoV-2 patients with stage 3 acute renal failure.

摘要

简介

在美国食品药品监督管理局(FDA)批准使用治疗性血浆置换治疗严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)后,我们分析了其在所有其他已知疗法均失败的患者中的疗效。

方法

这是一项对 42 名 SARS-CoV-2 患者的前瞻性观察性研究,这些患者在接受常规治疗后均失败,随后接受了治疗性血浆置换治疗。监测了置换前后的临床和实验室参数。然后,我们将这些患者与另外 147 名因 SARS-CoV-2 而出现 3 期急性肾衰竭并接受透析的患者进行比较。

结果

接受治疗性血浆置换后,一些临床参数有显著改善,但死亡率仍然很高;尽管比肾衰竭组(43.9%对 50.7%,p=0.004)好。

结论

所有其他疗法均失败的 SARS-CoV-2 患者接受治疗性血浆置换后死亡率仍然很高;然而,他们的生存率比出现 3 期急性肾衰竭的 SARS-CoV-2 患者要好。

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