Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000025.xml
Download PDF
Horm Metab Res 2022; 54(08): 571-577
DOI: 10.1055/a-1864-9482
DOI: 10.1055/a-1864-9482
Review
COVID-19 and Therapeutic Apheresis
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented challenge for the global community. The pathogenesis of COVID-19, its complications and long term sequelae (so called Long/Post-COVID) include, in addition to the direct virus-induced tissues injury, multiple secondary processes, such as autoimmune response, impairment of microcirculation, and hyperinflammation. Similar pathological processes, but in the settings of neurological, cardiovascular, rheumatological, nephrological, and dermatological diseases can be successfully treated by powerful methods of Therapeutic Apheresis (TA). We describe here the rationale and the initial attempts of TA treatment in severe cases of acute COVID-19. We next review the evidence for the role of autoimmunity, microcirculatory changes and inflammation in pathogenesis of Long/Post COVID and the rationale for targeting those pathogenic processes by different methods of TA. Finally, we discuss the impact of COVID-19 pandemic on patients, who undergo regular TA treatments due to their underlying chronic conditions, with the specific focus on the patients with inherited lipid diseases being treated at the Dresden University Apheresis Center.
Publication History
Received: 21 March 2022
Accepted after revision: 23 May 2022
Article published online:
09 August 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 COVID-19 dashboard by the center for systems science and engineering. Coronavirus resource center. Johns Hopkins University https://coronavirus.jhu.edu
- 2 Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr 2021; 15: 869-875
- 3 Mendoza-Pinto C, Garcia-Carrasco M, Munguia Realpozo P. et al. Therapeutic options for the management of severe COVID-19: a rheumatology perspective. Reumatol Clin (Engl Ed) 2021; 17: 431-436
- 4 Liu Y, Sawalha AH, Lu Q. COVID-19 and autoimmune diseases. Curr Opin Rheumatol 2021; 33: 155-162
- 5 Yazdanpanah N, Rezaei N. Autoimmune complications of COVID-19. J Med Virol 2022; 94: 54-62
- 6 Hohberger B, Ganslmayer M, Lucio M. et al. Retinal microcirculation as a correlate of a systemic capillary impairment after severe acute respiratory syndrome coronavirus 2 infection. Front Med (Lausanne) 2021; 8: 676554
- 7
Joob B,
Wiwanitkit V.
Blood viscosity of COVID-19 patient: a preliminary report. Am J Blood Res 2021; 11:
93-95
MissingFormLabel
- 8 Wallukat G, Hohberger B, Wenzel K. et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms. J Transl Autoimmun 2021; 4: 100100
- 9 Padmanabhan A, Connelly-Smith L, Aqui N. et al. Guidelines on the use of therapeutic apheresis in clinical practice – evidence-based approach from the writing committee of the American society for apheresis: The eighth special issue. J Clin Apher 2019; 34: 171-354
- 10 Sahin M, Yildiz A. Should the therapeutic apheresis method be added to treatment in the COVID-19 outbreak?. Blood Purif 2021; 50: 981-982
- 11 Bobati SS, Naik KR. Therapeutic plasma exchange – an emerging treatment modality in patients with neurologic and non-neurologic diseases. J Clin Diagn Res 2017; 11: EC35-EC37
- 12 Rimmer E, Houston BL, Kumar A. et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care 2014; 18: 699
- 13 Faqihi F, Alharthy A, Abdulaziz S. et al. Therapeutic plasma exchange in patients with life-threatening COVID-19: a randomised controlled clinical trial. Int J Antimicrob Agents 2021; 57: 106334
- 14 Kamran SM, Mirza ZE, Naseem A. et al. Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study. PLoS One 2021; 16: e0244853
- 15 Gluck WL, Callahan SP, Brevetta RA. et al. Efficacy of therapeutic plasma exchange in the treatment of penn class 3 and 4 cytokine release syndrome complicating COVID-19. Respir Med 2020; 175: 106188
- 16 de Prost N, Bastard P, Arrestier R. et al. Plasma exchange to rescue patients with autoantibodies against type I interferons and life-threatening COVID-19 pneumonia. J Clin Immunol 2021; 41: 536-544
- 17 Truong AD, Auld SC, Barker NA. et al. Therapeutic plasma exchange for COVID-19-associated hyperviscosity. Transfusion 2021; 61: 1029-1034
- 18 Mokrzycki MH, Balogun RA. Therapeutic apheresis: a review of complications and recommendations for prevention and management. J Clin Apher 2011; 26: 243-248
- 19 Grutzmacher P, Kleinert C. Lipid apheresis techniques: current status in Germany. Clin Res Cardiol Suppl 2012; 7: 20-23
- 20 Yang B, Yang J, Zhou L. et al. Inflammatory cytokine depletion in severe coronavirus disease 2019 infectious pneumonia: a case report. Medicine (Baltimore) 2020; 99: e23449
- 21 Cabral-Marques O, Halpert G, Schimke LF. et al. Autoantibodies targeting GPCRs and RAS-related molecules associate with COVID-19 severity. Nat Commun 2022; 13: 1220
- 22 Yavaşoğlu Z. Can plasmapheresis be useful in the treatment of patients with Covid-19?. Asian Hematol Res J 2020; 1-4
- 23 Curto D, Tomatis F, Gastoldi S. et al. Case report: effects of anti-SARS-CoV-2 convalescent antibodies obtained with double filtration plasmapheresis. Front Immunol 2021; 12: 711915
- 24 Al Shareef K, Bakouri M. Cytokine blood filtration responses in COVID-19. Blood Purif 2021; 50: 141-149
- 25 Smiechowicz J. The rationale and current status of endotoxin adsorption in the treatment of septic shock. J Clin Med 2022; 11: 619
- 26 Yigenoglu TN, Ulas T, Dal MS. et al. Extracorporeal blood purification treatment options for COVID-19: The role of immunoadsorption. Transfus Apher Sci 2020; 59: 102855
- 27 Schumann C, Heigl F, Rohrbach IJ. et al. A report on the first 7 sequential patients treated within the C-reactive protein apheresis in COVID (CACOV) registry. Am J Case Rep 2022; 23: e935263
- 28 Moriarty PM, Gorby LK, Stroes ES. et al. Lipoprotein(a) and its potential association with thrombosis and inflammation in COVID-19: a testable hypothesis. Curr Atheroscler Rep 2020; 22: 48
- 29 Tselmin S, Julius U, Muller G. et al. Cardiovascular events in patients with increased lipoprotein (a) – retrospective data analysis in an outpatient department of lipid disorders. Atheroscler Suppl 2009; 10: 79-84
- 30 Yang XH, Sun RH, Zhao MY. et al. Expert recommendations on blood purification treatment protocol for patients with severe COVID-19. Chronic Dis Transl Med 2020; 6: 106-114
- 31 Leung TYM, Chan AYL, Chan EW. et al. Short- and potential long-term adverse health outcomes of COVID-19: a rapid review. Emerg Microbes Infect 2020; 9: 2190-2199
- 32 Koczulla AR, Ankermann T, Behrends U. et al. S1-Leitlinie Post-COVID/Long-COVID https://www.awmf.org , accessed on 10.05.2022
- 33 Huang L, Yao Q, Gu X. et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet 2021; 398: 747-758
- 34 Mendelson M, Nel J, Blumberg L. et al. Long-COVID: An evolving problem with an extensive impact. S Afr Med J 2020; 111: 10-12
- 35 Mandal S, Barnett J, Brill SE. et al. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax 2021; 76: 396-398
- 36 Blaut-Jurkowska J, Jurkowski M. [Post-Lyme disease syndrome]. Pol Merkur Lekarski 2016; 40: 129-133
- 37 Leis AA, Stokic DS. Neuromuscular manifestations of west nile virus infection. Front Neurol 2012; 3: 37
- 38 Carod-Artal FJ. Post-Ebolavirus disease syndrome: what do we know?. Expert Rev Anti Infect Ther 2015; 13: 1185-1187
- 39 Komaroff AL, Bateman L. Will COVID-19 lead to myalgic encephalomyelitis/chronic fatigue syndrome?. Front Med (Lausanne) 2020; 7: 606824
- 40 Dotan A, Muller S, Kanduc D. et al. The SARS-CoV-2 as an instrumental trigger of autoimmunity. Autoimmun Rev 2021; 20: 102792
- 41 Dotan A, Shoenfeld Y. Covid-19 and Autoimmune Diseases. Harefuah. 2021; 160: 62-67
- 42 Malkova A, Kudlay D, Kudryavtsev I. et al. Immunogenetic predictors of severe COVID-19. Vaccines (Basel) 2021; 9: 211
- 43 Koning R, Bastard P, Casanova JL. et al. Autoantibodies against type I interferons are associated with multi-organ failure in COVID-19 patients. Intensive Care Med 2021; 47: 704-706
- 44 Zuo Y, Yalavarthi S, Navaz S. et al. Autoantibodies stabilize neutrophil extracellular traps in COVID-19. JCI Insight 2021; 6: e150111
- 45 Troya J, Bastard P, Planas-Serra L. et al. Neutralizing autoantibodies to type I IFNs in>10% of patients with severe COVID-19 pneumonia hospitalized in Madrid, Spain. J Clin Immunol 2021; 41: 914-922
- 46 Bastard P, Orlova E, Sozaeva L. et al. Preexisting autoantibodies to type I IFNs underlie critical COVID-19 pneumonia in patients with APS-1. J Exp Med 2021; 218: 1-15
- 47
Sotzny F,
Blanco J,
Capelli E.
et al. Myalgic encephalomyelitis/chronic fatigue syndrome – evidence
for an autoimmune disease. Autoimmun Rev 2018; 17: 601-609
MissingFormLabel
- 48 Silva Andrade B, Siqueira S, de Assis Soares WR. et al. Long-COVID and post-COVID health complications: An up-to-date review on clinical conditions and their possible molecular mechanisms. Viruses 2021; 13: 700
- 49 Perrin R, Riste L, Hann M. et al. Into the looking glass: post-viral syndrome post COVID-19. Med Hypotheses 2020; 144: 110055
- 50 Wang JY, Zhang W, Roehrl MW. et al. An autoantigen profile of human A549 lung cells reveals viral and host etiologic molecular attributes of autoimmunity in COVID-19. J Autoimmun 2021; 120: 102644
- 51 Richter AG, Shields AM, Karim A. et al. Establishing the prevalence of common tissue-specific autoantibodies following severe acute respiratory syndrome coronavirus 2 infection. Clin Exp Immunol 2021; 205: 99-105
- 52 Bertin D, Kaphan E, Weber S. Persistent IgG anticardiolipin autoantibodies are associated with post-COVID syndrome. Int J Infect Dis 2021; 113: 23-25
- 53
Loebel M,
Grabowski P,
Heidecke H.
et al. Antibodies to beta adrenergic and muscarinic cholinergic receptors in patients
with chronic fatigue syndrome. Brain Behav Immun 2016; 52: 32-39
MissingFormLabel
- 54 Fluge O, Bruland O, Risa K. et al. Benefit from B-lymphocyte depletion using the anti-CD20 antibody rituximab in chronic fatigue syndrome. A double-blind and placebo-controlled study. PLoS One 2011; 6: e26358
- 55 McDonald EM, Mann AH, Thomas HC. Interferons as mediators of psychiatric morbidity. An investigation in a trial of recombinant alpha-interferon in hepatitis-B carriers. Lancet 1987; 2: 1175-1178
- 56 Strawbridge R, Sartor ML, Scott F. et al. Inflammatory proteins are altered in chronic fatigue syndrome: a systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 107: 69-83
- 57 Maes M, Twisk FN. Why myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may kill you: disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS. Neuro Endocrinol Lett 2009; 30: 677-693
- 58 Pierce JD, Shen Q, Cintron SA. et al. Post-COVID-19 syndrome. Nurs Res 2022; 71: 164-174
- 59 Kalyanaraman B. Reactive oxygen species, proinflammatory and immunosuppressive mediators induced in COVID-19: overlapping biology with cancer. RSC Chem Biol 2021; 2: 1402-1414
- 60 Costa DC, Tannock C, Brostoff J. Brainstem perfusion is impaired in chronic fatigue syndrome. QJM 1995; 88: 767-773
- 61 Leebmann J, Roeseler E, Julius U. et al. Lipoprotein apheresis in patients with maximally tolerated lipid-lowering therapy, lipoprotein(a)-hyperlipoproteinemia, and progressive cardiovascular disease: prospective observational multicenter study. Circulation 2013; 128: 2567-2576
- 62 Mabuchi H, Koizumi J, Shimizu M. et al. Long-term efficacy of low-density lipoprotein apheresis on coronary heart disease in familial hypercholesterolemia. Hokuriku-FH-LDL-Apheresis Study Group. Am J Cardiol 1998; 82: 1489-1495
- 63 Julius U, Siegert G, Kostka H. et al. Effects of different lipoprotein apheresis methods on serum protein levels. Atheroscler Suppl 2015; 18: 95-102
- 64 Klingel R, Fassbender C, Fischer I. et al. Rheopheresis for age-related macular degeneration: a novel indication for therapeutic apheresis in ophthalmology. Ther Apher 2002; 6: 271-281
- 65 Rossler A, Berrouschot J, Barthel H. et al. Potential of rheopheresis for the treatment of acute ischemic stroke when initiated between 6 and 12 hours. Ther Apher 2000; 4: 358-362
- 66
Hatano Y,
Katagiri K,
Arakawa S.
et al. Successful treatment by double-filtration plasmapheresis of a patient with
bullous pemphigoid: effects in vivo on transcripts of several genes for
chemokines and cytokines in peripheral blood mononuclear cells. Br J Dermatol 2003;
148: 573-579
MissingFormLabel
- 67 Tselmin SHA, Schäfer J, Hohesntein B. et al. Nebenwirkung wandelt sich in einen Vorteil. Cardiovasc 2017; 17: 44-45
- 68 Lin JH, Tu KH, Chang CH. et al. Prognostic factors and complication rates for double-filtration plasmapheresis in patients with Guillain-Barre syndrome. Transfus Apher Sci 2015; 52: 78-83
- 69 Munemoto M, Otaki Y, Kasama S. et al. Therapeutic efficacy of double filtration plasmapheresis in patients with anti-aquaporin-4 antibody-positive multiple sclerosis. J Clin Neurosci 2011; 18: 478-480
- 70 Xing Y, Wang S, Liu C. et al. Efficacy and safety of dual filtration plasmapheresis combined with biological agents in active refractory rheumatod arthritis: a retrospective cohort study. Medicine (Baltimore) 2020; 99: e20966
- 71 Lumlertgul D, Suteeka Y, Tumpong S. et al. Double filtration plasmapheresis in different diseases in Thailand. Ther Apher Dial 2013; 17: 99-116
- 72 Hohenstein B, Passauer J, Ziemssen T. et al. Immunoadsorption with regenerating systems in neurological disorders – a single center experience. Atheroscler Suppl 2015; 18: 119-123
- 73 Dietze J, Hohenstein B, Tselmin S. et al. Successful and well-tolerated bi-weekly immunoadsorption regimen in pemphigus vulgaris. Atheroscler Suppl 2017; 30: 271-277
- 74 Hohenstein B, Bornstein SR, Aringer M. Immunoadsorption for connective tissue disease. Atheroscler Suppl 2013; 14: 185-189
- 75 Opgenoorth M, Wagner A, Passauer J. et al. Treatment of antibody-mediated rejection including immunoadsorption during first year after renal transplantation -- clinical results and regulation of endothelial progenitor cells. Atheroscler Suppl 2015; 18: 67-73
- 76 Tselmin S, Julius U, Bornstein SR. et al. Low rate of infectious complications following immunoadsorption therapy without regular substitution of intravenous immunoglobulins. Atheroscler Suppl 2017; 30: 278-282
- 77 van Buuren F, Kreickmann S, Horstkotte D. et al. HELP apheresis in hypercholesterolemia and cardiovascular disease: efficacy and adverse events after 8,500 procedures. Clin Res Cardiol Suppl 2012; 7: 24-30
- 78 Bianchin G, Russi G, Romano N. et al. Treatment with HELP-apheresis in patients suffering from sudden sensorineural hearing loss: a prospective, randomized, controlled study. Laryngoscope 2010; 120: 800-807
- 79 Suckfull M, Seidel D, Thiery J. et al. [Treatment of sudden hearing loss through Fibrinogen/LDL-apheresis. A prospective, randomized multicenter trial]. Z Kardiol 2003; 92: III59-III63
- 80 Walch C, Anderhuber W, Walzl M. H.E.L.P. therapy (heparin-induced extracorporeal LDL precipitation) in sudden deafness. Laryngorhinootologie 1996; 75: 641-645
- 81 Weck M, Slesaczeck T, Rietzsch H. et al. Noninvasive management of the diabetic foot with critical limb ischemia: current options and future perspectives. Ther Adv Endocrinol Metab 2011; 2: 247-255
- 82 Walzl M, Walzl B, Kleinert G. et al. Heparin-induced extracorporeal LDL precipitation (HELP). A new therapeutic possibility in cerebral multi-infarct dementia. Nervenarzt 1993; 64: 648-652
- 83 Pulawski E, Mellwig KP, Horstkotte D. [H.E.L.P. apheresis and oxidative stress]. Z Kardiol 2003; 92: III38-III41
- 84 Yamada C, Hofmann JC, Witt V. et al. The report from ASFA COVID-19 taskforce: considerations and prioritization on apheresis procedures during the SARS-CoV-2 coronavirus disease (COVID-19) pandemic. J Clin Apher 2021; 36: 878-881
- 85 Sbrana F, Dal Pino B, Bigazzi F. et al. COVID-19 swab collection and serological screening in lipoprotein apheresis unit. J Clin Apher 2020; 35: 382-383
- 86 Singh NJ, McLeod M, Boshell MN. et al. Social distancing in apheresis medicine. Transfusion 2020; 60: 2758-2759
- 87 Kayikcioglu M, Tokgozoglu L, Tuncel OK. et al. Collateral damage of the COVID-19 pandemic on the management of homozygous familial hypercholesterolemia. J Clin Lipidol 2021; 15: 381-382
- 88 Xie Y, Xu E, Bowe B. et al. Long-term cardiovascular outcomes of COVID-19. Nat Med 2022; 28: 583-590
- 89 Katsoularis I, Fonseca-Rodriguez O, Farrington P. et al. Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet 2021; 398: 599-607
- 90 Bornstein SR, Voit-Bak K, Donate T. et al. Chronic post-COVID-19 syndrome and chronic fatigue syndrome: is there a role for extracorporeal apheresis?. Mol Psychiatr 2022; 27: 34-37