Efficacy of Plasmapheresis and Immunoglobulin Replacement Therapy (IVIG) on Patients with COVID-19
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COVID-19
Efficacy of Plasmapheresis and Immunoglobulin Replacement Therapy (IVIG) on Patients with COVID-19 Ramtin Pourahmad 1 & Bobak Moazzami 1,2 & Nima Rezaei 1,2 Accepted: 28 July 2020 # Springer Nature Switzerland AG 2020
Abstract Since the rapidly evolving outbreak of COVID-19, several empirical therapeutic options have been recommended including the use of antivirals, steroids, and vaccines. According to recent observations about different modalities in treatment of patients infected with COVID-19, plasmapheresis and intravenous immunoglobulin (IVIg) have been reported to be an effective empirical therapeutic option to control the infection. In this review, we aimed to provide an overview on the possible application of plasmapheresis and intravenous immunoglobulin in patients with COVID-19. Keywords COVID-19 . Coronavirus . Treatment . Plasmapheresis . Intravenous immunoglobulin
Introduction In December 2019, a new member of the coronaviruses emerged in Wuhan, China. The World Health Organization (WHO) declared this novel coronavirus as a “Public Health Emergency of International Concern (PHEIC)” in January 31, 2020. The WHO officially named the 2019-nCoV as coronavirus disease 2019 (COVID-19) in Geneva, Switzerland. According to the WHO reports, the clinical spectrum of SARS-CoV-2 is wide and can be classified in 3 groups: patients with asymptomatic infection (mild type) with upper respiratory tract distress, patients with pulmonary infiltration (common type), and patients with severe signs that need intubation and intensive care (severe type). To date, several empirical therapeutic options have been recommended, including generation of antivirals, steroids, and vaccines. However, the optimal and definite treatment strategy is not yet determined. According to the medical experiences in the treatment of patients infected with other
* Nima Rezaei [email protected]; http://usern.tums.ac.ir/User/CV/ rezaei_nima 1
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
2
Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
members of coronavirus family such as SARS-CoV and MERS-CoV, plasmapheresis and intravenous immunoglobulin (IVIg) have been reported to be an effective empirical therapeutic option to control the infection [1–7]. The aim of the present review was to evaluate the current evidence regarding the efficacy of plasmapheresis and IVIg in the management of patients with COVID-19.
SARS-CoV-2 Coronaviruses (CoVs) as a member of the Coronaviridae family comprised large, single, and positive-sense RNA categorized into 4 subgroups: alpha, beta, gamma, and delta CoVs [8, 9]. Among these 4 subgroups, 6 human CoVs (HCoVs) have been identified that can cause infection in human: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, severe acute respiratory syndrome (SARS-CoV), and Middle East respiratory syndrome coronavirus (MERS-CoV) [10]. In addition,
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