A randomised controlled trial of plasma exchange compared to standard of care in the treatment of severe COVID-19 infection (COVIPLEX).
Humans
COVID-19
/ therapy
Male
Female
Plasma Exchange
/ methods
Middle Aged
Aged
Standard of Care
Respiratory Insufficiency
/ therapy
Prospective Studies
SARS-CoV-2
/ isolation & purification
Thrombosis
/ etiology
Biomarkers
/ blood
Treatment Outcome
Adult
Fibrin Fibrinogen Degradation Products
/ analysis
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
23 Jul 2024
23 Jul 2024
Historique:
received:
19
12
2023
accepted:
08
07
2024
medline:
24
7
2024
pubmed:
24
7
2024
entrez:
23
7
2024
Statut:
epublish
Résumé
COVID-19 disease is associated with a hyperinflammatory, pro-thrombotic state and a high mortality. Our primary objective was to assess the change in inflammatory and thrombotic markers associated with PEX, and secondary objectives were to assess the effects of PEX on progression of respiratory failure and incidence of acute thrombotic events. We conducted a prospective, phase II, non-blinded randomised control trial of plasma exchange compared to standard of care in critically ill adults with severe COVID-19 associated respiratory failure, requiring supplemental oxygen or ventilatory support and elevated thrombo-inflammatory markers (LDH, CRP, ferritin, and D-Dimer). Patients randomised to receive PEX were treated with a daily single volume plasma exchange for a minimum of five days. Twenty-two patients were randomised of who 11 received PEX. Demographic and clinical characteristics were similar between groups at presentation. PEX was associated with a significant reduction in pro-thrombotic markers FVIII, VWF and VWF Ag: ADAMTS 13 ratio (p < 0.001). There were no differences in the reduction of inflammatory markers, severity of respiratory failure (p = 0.7), thrombotic events (p = 0.67), or mortality (p > 0.99) at 28 days. PEX successfully reduced pro-thrombotic markers, although was not associated with reduction in inflammatory markers, respiratory failure, or thrombotic events.Trial registration: (NCT04623255); first posted on 10/11/2020.
Identifiants
pubmed: 39043682
doi: 10.1038/s41598-024-67028-3
pii: 10.1038/s41598-024-67028-3
doi:
Substances chimiques
Biomarkers
0
fibrin fragment D
0
Fibrin Fibrinogen Degradation Products
0
Banques de données
ClinicalTrials.gov
['NCT04623255']
Types de publication
Journal Article
Randomized Controlled Trial
Clinical Trial, Phase II
Langues
eng
Sous-ensembles de citation
IM
Pagination
16876Subventions
Organisme : Medical Research Council
ID : MR/W030489/1
Pays : United Kingdom
Informations de copyright
© 2024. Crown.
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