Introduction
infection, death, tumor necrosis
VIRUS, TUMOR NECROSIS, DISEASE, CYTOKINE RELEASE SYNDROME, INFECTION, ACUTE RESPIRATORY FAILURE, CORONAVIRUS, SEVERE ACUTE RESPIRATORY SYNDROME, MULTI-ORGAN FAILURE
Since December 2019, health workers and governments around the world have been fighting a virus that changed our lives. COVID-19 is an infection caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)Coronavirus disease is characterized by a wide spectrum of manifestations, ranging from asymptomatic to acute respiratory failure, multi-organ failure, and death, the result of macrophage activation and cytokine stormThe severity of COVID-19 is associated with host response and increased release of inflammatory mediators including cytokines and chemokines such as interleukin (IL) -2, IL-6, IL-7, IL-10, tumor necrosis factor (TNF), C-reactive protein (CRP), ferritin, and D-dimer in blood after SARS-CoV-2 replicationEffective antiviral treatment and measures to modulate the innate immune response and restore the adaptive immune response are imperative to break the cycle and enhance the effect of treatment. Some drug therapies would take weeks or months to remove these pro-inflammatory factors, while plasma exchange therapy (PLEX) is able to effectively remove these large moleculesThe effectiveness of PLEX depends on the plasma volume (PV) removed from the patient, on the distribution of the pathogen to be removed. One exchange (1:1) is equivalent to 65% of the initial component removed from the intravascular space. The first session of PLEX, which is prescribed with 1.5 plasma volume, removes approximately 75% of target molecules from the intravascular compartment, while the second session achieves a removal of 85% of target moleculesThis trial aimed to evaluate the impact of plasmapheresis therapy on the survival of patients with severe SARS-CoV-2 and cytokine release syndrome who received at least two sessions during their hospitalization compared against standard therapy.