Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis

Background: The fulminant course of COVID-19, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with a high mortality rate and still lacks a causative treatment. C-reactive protein (CRP) has been shown to increase dramatically during the disease progression and corr...

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Main Authors: Fabrizio Esposito, Harald Matthes, Friedemann Schad
Format: Article
Language:English
Published: MDPI AG 2022-04-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/7/1956
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author Fabrizio Esposito
Harald Matthes
Friedemann Schad
author_facet Fabrizio Esposito
Harald Matthes
Friedemann Schad
author_sort Fabrizio Esposito
collection DOAJ
description Background: The fulminant course of COVID-19, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with a high mortality rate and still lacks a causative treatment. C-reactive protein (CRP) has been shown to increase dramatically during the disease progression and correlates with deleterious outcomes. Selective CRP apheresis can reduce circulating CRP levels fast and effective. Methods: Seven hospitalized patients with documented severe COVID-19 progression, elevated CRP plasma levels (>100 mg/L) and signs of respiratory failure were treated with CRP apheresis. Two to twelve CRP apheresis sessions were performed generally in 24 h time intervals and depending on CRP plasma levels. Results: All patients had comorbidities. CRP apheresis reduced CRP plasma levels by up to 84% within a few hours, without exhibiting side effects in any patient. Despite signs of severe lung infiltration in all patients, only one patient died. The other patients showed improvements within the chest X-ray after CRP apheresis and were able to recover regardless of intubation and/or ECMO (4 patients). All remaining six patients were discharged from the hospital in good clinical condition. Conclusions: This case series presents a mortality rate of only 14%, which is dramatically lower than expected from the presented CRP levels as well as comorbidities and ventilation requirements. Our clinical observations regarding the here presented seven patients support the hypothesis that CRP is a candidate to be therapeutically targeted in the early stage of severe COVID-19.
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spelling doaj.art-7f18f52c16ae4c62a424104df56ffe532023-11-30T23:29:11ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01117195610.3390/jcm11071956Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) ApheresisFabrizio Esposito0Harald Matthes1Friedemann Schad2Intensiv-Notfallmedizin und Kardiologie, Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, GermanyGastroenterologie, Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, GermanyInterdisziplinäre Onkologie und Supportivmedizin, Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, GermanyBackground: The fulminant course of COVID-19, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with a high mortality rate and still lacks a causative treatment. C-reactive protein (CRP) has been shown to increase dramatically during the disease progression and correlates with deleterious outcomes. Selective CRP apheresis can reduce circulating CRP levels fast and effective. Methods: Seven hospitalized patients with documented severe COVID-19 progression, elevated CRP plasma levels (>100 mg/L) and signs of respiratory failure were treated with CRP apheresis. Two to twelve CRP apheresis sessions were performed generally in 24 h time intervals and depending on CRP plasma levels. Results: All patients had comorbidities. CRP apheresis reduced CRP plasma levels by up to 84% within a few hours, without exhibiting side effects in any patient. Despite signs of severe lung infiltration in all patients, only one patient died. The other patients showed improvements within the chest X-ray after CRP apheresis and were able to recover regardless of intubation and/or ECMO (4 patients). All remaining six patients were discharged from the hospital in good clinical condition. Conclusions: This case series presents a mortality rate of only 14%, which is dramatically lower than expected from the presented CRP levels as well as comorbidities and ventilation requirements. Our clinical observations regarding the here presented seven patients support the hypothesis that CRP is a candidate to be therapeutically targeted in the early stage of severe COVID-19.https://www.mdpi.com/2077-0383/11/7/1956blood component removalC-reactive proteinCRP apheresisCOVID-19multiple organ failurepulmonary fibrosis
spellingShingle Fabrizio Esposito
Harald Matthes
Friedemann Schad
Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
Journal of Clinical Medicine
blood component removal
C-reactive protein
CRP apheresis
COVID-19
multiple organ failure
pulmonary fibrosis
title Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
title_full Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
title_fullStr Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
title_full_unstemmed Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
title_short Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis
title_sort seven covid 19 patients treated with c reactive protein crp apheresis
topic blood component removal
C-reactive protein
CRP apheresis
COVID-19
multiple organ failure
pulmonary fibrosis
url https://www.mdpi.com/2077-0383/11/7/1956
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