Dataset Information

Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study.

ABSTRACT:

Background

Cytokine release syndrome (CRS) plays a pivotal role in the pathophysiology and progression of Coronavirus disease-2019 (COVID-19). Therapeutic plasma exchange (TPE) by removing the pathogenic cytokines is hypothesized to dampen CRS.

Objective

To evaluate the outcomes of the patients with COVID-19 having CRS being treated with TPE compared to controls on the standard of care.

Methodology

Retrospective propensity score-matched analysis in a single centre from 1st April to 31st July 2020. We retrospectively analyzed data of 280 hospitalized patients developing CRS initially. PSM was used to minimize bias from non-randomized treatment assignment. Using PSM 1:1, 90 patients were selected and assigned to 2 equal groups. Forced matching was done for disease severity, routine standard care and advanced supportive care. Many other Co-variates were matched. Primary outcome was 28 days overall survival. Secondary outcomes were duration of hospitalization, CRS resolution time and timing of viral clearance on Polymerase chain reaction testing.

Results

After PS-matching, the selected cohort had a median age of 60 years (range 32-73 in TPE, 37-75 in controls), p = 0.325 and all were males. Median symptoms duration was 7 days (range 3-22 days' TPE and 3-20 days controls), p = 0.266. Disease severity in both groups was 6 (6.6%) moderate, 40 (44.4%) severe and 44 (49%) critical. Overall, 28-day survival was significantly superior in the TPE group (91.1%), 95% CI 78.33-97.76; as compared to PS-matched controls (61.5%), 95% CI 51.29-78.76 (log rank 0.002), p<0.001. Median duration of hospitalization was significantly reduced in the TPE treated group (10 days vs 15 days) (p< 0.01). CRS resolution time was also significantly reduced in the TPE group (6 days vs. 12 days) (p< 0.001). In 71 patients who underwent TPE, the mortality was 0 (n = 43) if TPE was done within the first 12 days of illness while it was 17.9% (deaths 5, n = 28 who received it after 12th day (p = 0.0045).

Conclusion

An earlier use of TPE was associated with improved overall survival, early CRS resolution and time to discharge compared to SOC for COVID-19 triggered CRS in this selected cohort of PS-matched male patients from one major hospital in Pakistan.

SUBMITTER: Kamran SM

PROVIDER: S-EPMC7790281 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study.

Kamran Sultan Mehmood SM Mirza Zill-E-Humayun ZE Naseem Arshad A Liaqat Jahanzeb J Fazal Imran I Alamgir Wasim W Saeed Farrukh F Saleem Salman S Nisar Shazia S Yousaf Muhammad Ali MA Khan Asad Zaman AZ Hussain Mehmood M Azam Rizwan R Hussain Maryam M Khan Kumail Abbas KA Jamal Yousaf Y Iftikhar Raheel R

PloS one 20210107 1

<h4>Background</h4>Cytokine release syndrome (CRS) plays a pivotal role in the pathophysiology and progression of Coronavirus disease-2019 (COVID-19). Therapeutic plasma exchange (TPE) by removing the pathogenic cytokines is hypothesized to dampen CRS.<h4>Objective</h4>To evaluate the outcomes of the patients with COVID-19 having CRS being treated with TPE compared to controls on the standard of care.<h4>Methodology</h4>Retrospective propensity score-matched analysis in a single centre from 1st ...[more]

PMID: 33411791

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Dataset Information

Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study.

Background

Objective

Methodology

Results

Conclusion

Publications

Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study.

Similar Datasets

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