Efficacy of therapeutic plasma exchange in severe COVID-19 disease: A meta-analysis.
Vox Sang
; 118(1): 49-58, 2023 Jan.
Article
en En
| MEDLINE
| ID: mdl-36254849
ABSTRACT
BACKGROUND AND OBJECTIVES:
Therapeutic plasma exchange (TPE) has been used in severe COVID-19 disease to eliminate the cytokine storm. This meta-analysis aims to assess the effectiveness of TPE in reducing mortality in severe COVID-19 disease compared to standard treatment. MATERIALS ANDMETHODS:
A comprehensive literature search was performed in PubMed, the Cochrane database and the International Clinical Trial Registry Platform (ICTRP). The random-effect model was used to calculate the risk ratio and standardized mean difference (SMD) as pooled effect size for the difference in mortality and length of the intensive care unit (ICU) stay. The risk of bias and publication bias were assessed in R version 4.1.0. The certainty of the evidence was calculated using the GradePro tool.RESULTS:
The database identified 382 participants from six studies, including one randomized control trial. Egger's test did not detect any publication bias (p = 0.178). The random model analysis for mortality evaluated a risk ratio of 0.38 (95% CI 0.28-0.52) with a significant reduction in the TPE group. The certainty of the evidence was moderate, with a risk ratio of 0.34 (95% CI 0.24-0.49). Length of ICU stays between TPE versus standard care showed an SMD of 0.08 (95% CI -0.38, 0.55) and was not significant.CONCLUSION:
The length of ICU stay in the TPE group was not different from standard care. However, this meta-analysis revealed a significant benefit of TPE in reducing mortality in severe COVID-19 disease compared to standard treatment.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
COVID-19
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Vox Sang
Año:
2023
Tipo del documento:
Article
País de afiliación:
India