Therapeutic plasma exchange (TPE) as an effective supportive therapy for COVID-19 case with acute respiratory distress syndrome (ARDS) and thrombophilia: a case report

Reviono, Reviono; Arifin, Arifin; en,

Coronavirus Disease (COVID-19) has rapidly spread and caused a high number of mortalities. To this day, effective therapy to cure this virus is yet to be found. A number of treatments were tested;however, the result is not satisfactory. Therapeutic plasma exchange (TPE) is one of the supportive therapies applied to treat COVID-19 patients with moderate to severe symptoms. We reported 41 years old male patient diagnosed with severe COVID-19 infection, acute respiratory distress syndrome (ARDS), and thrombophilia. The patient received a therapy following the Ministry of Health’s guideline for COVID-19 handling. On the third day, respiratory failure occurred with a P/F ratio of 255 and the chest X-ray result showed vascular streak and ground-glass opacity;thus, the hospital decided to perform TPE. The TPE was performed twice in 5 days interval. After TPE was administered, clinical development is observed both subjectively in the form of reduced symptoms, normal respiration rate, and objectively, the improvement in blood gas analysis, increased O2 saturation, and a decrease in interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) level significant clinical laboratory and radiological improvement possibly due to cytokine storm which is remedied by TPE action.