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

Abstract

IntroductionAfter 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.MethodsThis 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.ResultsAfter 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).ConclusionSARS‐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.