COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy
COVID-19-associated thrombotic microangiopathy has emerged as a severe complication that exacerbates morbidity and mortality in critical cases. Thrombotic microangiopathy, characterized by microvascular thrombosis and endothelial injury, includes conditions like thrombotic thrombocytopenic purpura a...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-10-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137925002317 |
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| _version_ | 1849226938389889024 |
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| author | Yigit Baykara Kaan Sevgi Yamac Akgun |
| author_facet | Yigit Baykara Kaan Sevgi Yamac Akgun |
| author_sort | Yigit Baykara |
| collection | DOAJ |
| description | COVID-19-associated thrombotic microangiopathy has emerged as a severe complication that exacerbates morbidity and mortality in critical cases. Thrombotic microangiopathy, characterized by microvascular thrombosis and endothelial injury, includes conditions like thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome. This review investigates therapeutic plasma exchange as a potential strategy to mitigate COVID-19-induced thrombotic microangiopathy, examining its role in removing pro-inflammatory cytokines, immune complexes, and pro-thrombotic factors. Additionally, it highlights the synergistic effects when therapeutic plasma exchange is combined with treatments such as complement inhibitors and immunosuppressants. Preliminary evidence, drawn from case reports and early trials, supports the efficacy of therapeutic plasma exchange in improving outcomes for COVID-19-associated thrombotic microangiopathy. However, larger randomized controlled trials are necessary to definitively establish its place in COVID-19 management, particularly for high-risk and transplant patients with underlying immunological vulnerabilities. |
| format | Article |
| id | doaj-art-7041c07ac2ea43988d41626099303549 |
| institution | Kabale University |
| issn | 2531-1379 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-7041c07ac2ea43988d416260993035492025-08-24T05:13:59ZengElsevierHematology, Transfusion and Cell Therapy2531-13792025-10-0147410396310.1016/j.htct.2025.103963COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategyYigit Baykara0Kaan Sevgi1Yamac Akgun2Stanford University Department of Pathology, Stanford, USAKansas City University of Medicine and Biosciences, Kansas City, MO, USAUniversity of Miami Miller School of Medicine, Miami, FL, USA; Corresponding author at: Children's Hospital Los Angeles, USA.COVID-19-associated thrombotic microangiopathy has emerged as a severe complication that exacerbates morbidity and mortality in critical cases. Thrombotic microangiopathy, characterized by microvascular thrombosis and endothelial injury, includes conditions like thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome. This review investigates therapeutic plasma exchange as a potential strategy to mitigate COVID-19-induced thrombotic microangiopathy, examining its role in removing pro-inflammatory cytokines, immune complexes, and pro-thrombotic factors. Additionally, it highlights the synergistic effects when therapeutic plasma exchange is combined with treatments such as complement inhibitors and immunosuppressants. Preliminary evidence, drawn from case reports and early trials, supports the efficacy of therapeutic plasma exchange in improving outcomes for COVID-19-associated thrombotic microangiopathy. However, larger randomized controlled trials are necessary to definitively establish its place in COVID-19 management, particularly for high-risk and transplant patients with underlying immunological vulnerabilities.http://www.sciencedirect.com/science/article/pii/S2531137925002317COVID-19Plasma exchangeThrombotic microangiopathyCoagulopathy |
| spellingShingle | Yigit Baykara Kaan Sevgi Yamac Akgun COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy Hematology, Transfusion and Cell Therapy COVID-19 Plasma exchange Thrombotic microangiopathy Coagulopathy |
| title | COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy |
| title_full | COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy |
| title_fullStr | COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy |
| title_full_unstemmed | COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy |
| title_short | COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy |
| title_sort | covid 19 microangiopathy insights into plasma exchange as a therapeutic strategy |
| topic | COVID-19 Plasma exchange Thrombotic microangiopathy Coagulopathy |
| url | http://www.sciencedirect.com/science/article/pii/S2531137925002317 |
| work_keys_str_mv | AT yigitbaykara covid19microangiopathyinsightsintoplasmaexchangeasatherapeuticstrategy AT kaansevgi covid19microangiopathyinsightsintoplasmaexchangeasatherapeuticstrategy AT yamacakgun covid19microangiopathyinsightsintoplasmaexchangeasatherapeuticstrategy |