The association between therapeutic plasma exchange and the risk of mortality among patients critically ill with COVID-19: a meta-analysis.

Shinta Oktya Wardhani,Jonny Karunia Fajar,Gatot Soegiarto,Dessy Aprilia Kartini,Nenci Siagian,Komang Noviantari,Juliansyah Juliansyah,Fitri Aulia,Fikri Baladraf,Ponda Hernest Hadinata,Risna Merysa,Aditya Indra Mahendra,Laksmi Wulandari,Sri Nining,Risyda Zakiyah Hanim,Maria Yoheni Harnila,Harapan Harapan,Arlentina Bentivolia Simamora,Qurrata Aini,Wahyuni Wahyuni,Milda Husnah,Amanda Cininta Wowor,Firzan Nainu,Reflin Mahmud,Fredo Tamara,Adhityari Ikkeputri,Muhammad Ilmawan,Hana Nadya,Jane Andrea Christiano Djianzonie,Helnida Anggun Maliga,Ayu Lestari ,Imam Syafi’i

doi:10.12688/f1000research.74972.1

Abstract

Background: Cytokine storm has been widely known to contribute to the development of the critical condition in patients with coronavirus disease 2019 (COVID-19), and studies had been conducted to assess the potential aspect of cytokine storm elimination by performing therapeutic plasma exchange (TPE). However, contradictory findings were observed. The objective of this study was to assess the association between TPE and the reduction of mortality of critically ill COVID-19 patients. Methods: A meta-analysis was conducted by collecting data from PubMed, Scopus, and Web of Science. Data on the mortality rate of critically ill COVID-19 patients treated with TPE plus standard of care and that of patients treated with standard of care alone were analyzed using a Z test. Results: We included a total of four papers assessing the association between TPE and the risk of mortality among critically ill COVID-19 patients. Our findings suggested that critically ill COVID-19 patients treated with TPE had lower risk of mortality compared to those without TPE treatment. Conclusion: Our study has identified the potential benefits of TPE in reducing the risk of mortality among critically ill COVID-19 patients.

Highlights

Since first reported in December 2019,1 coronavirus disease 2019 (COVID-19) has become an unresolved global pandemic
Patients critically ill with COVID-19 have been widely reported to have a poor prognosis, and theory reveals that cytokine storm might underlie this mechanism
Our results found that COVID-19 patients treated with therapeutic plasma exchange (TPE) had reduced mortality rate compared to COVID-19 patients without TPE treatment (OR: 0.21; 95% CI: 0.05, 0.85) (Figure 2)

Summary

Introduction

Since first reported in December 2019,1 coronavirus disease 2019 (COVID-19) has become an unresolved global pandemic. No study has found an effective treatment for the management of a cytokine storm in patients critically ill with COVID-19. Cytokine storm has been widely known to contribute to the development of the critical condition in patients with coronavirus disease 2019 (COVID-19), and studies had been conducted to assess the potential aspect of cytokine storm elimination by performing therapeutic plasma exchange (TPE). The objective of this study was to assess the association between TPE and the reduction of mortality of critically ill COVID-19 patients. Results: We included a total of four papers assessing the association between TPE and the risk of mortality among critically ill COVID-19 patients. Our findings suggested that critically ill COVID-19 patients treated with TPE had lower risk of mortality compared to those without TPE treatment. Conclusion: Our study has identified the potential benefits of TPE in reducing the risk of mortality among critically ill COVID-19 patients

Objectives

Methods

Conclusion