Successful treatment with plasma exchange followed by intravenous immunoglobulin in a critically ill patient with COVID-19

Int J Antimicrob Agents. 2020 Aug;56(2):105974. doi: 10.1016/j.ijantimicag.2020.105974. Epub 2020 Apr 13.

Abstract

Here we report a case of a laboratory-confirmed 2019 novel coronavirus (2019-nCoV)-infected patient with COVID-19 (coronavirus disease 2019) who developed respiratory failure and shock accompanied by persistent diarrhoea despite conventional therapeutic interventions. The patient avoided mechanical ventilation and showed an immediate clinical and radiological improvement following treatment with intensive plasma exchange (PE) followed by intravenous immunoglobulin (IVIG). Successful therapeutic strategies in this case suggest that timely initiation of PE treatment followed by IVIG in critically ill patients with COVID-19 may prevent the disease from worsening and help to reduce the requirement for mechanical ventilation and intensive supportive care. Moreover, it may improve poor clinical outcomes of these patients.

Keywords: 2019 novel coronavirus; COVID-19; Diarrhoea; Immunoglobulin; Plasma exchange; SARS-CoV-2.

MeSH terms

  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / virology
  • Critical Care
  • Critical Illness / therapy*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Pandemics
  • Plasma Exchange*
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / virology
  • Respiration, Artificial
  • SARS-CoV-2
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous