Therapeutic plasma exchange combined with ribavirin to rescue critical SFTS patients

IF 1.4 4区医学 Q4 HEMATOLOGY Journal of Clinical Apheresis Pub Date : 2024-06-08 DOI:10.1002/jca.22131

Xuezhen Song, Xiaojun Xu, Xiaoning Ren, Xiaoxuan Ruan, Jinshuang Bo

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Abstract

Background

Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic infectious disease caused by the severe fever with thrombocytopenia syndrome virus (SFTSV). Endemic in East Asia, SFTS is characterized by an exceptionally high mortality rate. Presently, there is no established treatment for SFTS, particularly for patients in critical condition. In this study, we collected and analyzed laboratory and clinical data from 92 critically ill patients with SFTS treated at Weihai Municipal Hospital between 2019 and 2022. We hope that our study will provide some hints for the treatment of critically ill patients with SFTS.

Methods

A total of 92 critically ill patients with SFTS were included in this study. Of these patients, 45 received treatment with therapeutic plasma exchange (TPE) and ribavirin (referred to as the TPE group), while the remaining patients received only ribavirin (referred to as the non-TPE group). Clinical and laboratory parameters were analyzed retrospectively.

Results

The results showed significant improvements in multiple laboratory parameters following treatment with TPE and ribavirin, including white blood cell and neutrophil count, lactate dehydrogenase, creatine kinase isoenzyme-MB, prothrombin time, activated partial thromboplastin time, D-Dimer, serum sodium and copies of virus genomes. The combination of TPE with ribavirin demonstrated a significant reduction in mortality rates, with a mortality rate of 20.0% in the TPE group compared to 40.4% in the non-TPE group (P = 0.033).

Conclusions

Our findings suggest that critically ill patients with SFTS who received TPE and ribavirin experienced improvements in both clinical and laboratory parameters. These results indicate that TPE combined with ribavirin may represent a promising novel therapeutic approach for managing critically ill patients with SFTS. However, comparative studies of large sample size or randomized clinical trials are warranted to confirm the effectiveness of this combination therapy in the treatment of severe SFTS cases.

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治疗性血浆置换联合利巴韦林抢救危重的 SFTS 患者。

背景：严重发热伴血小板减少综合征（SFTS）是一种由严重发热伴血小板减少综合征病毒（SFTSV）引起的人畜共患传染病。该病流行于东亚，死亡率极高。目前，还没有针对 SFTS 的成熟治疗方法，尤其是针对危重病人的治疗方法。在本研究中，我们收集并分析了威海市立医院在 2019 年至 2022 年期间收治的 92 名 SFTS 重症患者的实验室和临床数据。希望我们的研究能为SFTS危重症患者的治疗提供一些提示：本研究共纳入 92 名 SFTS 重症患者。其中，45 名患者接受了治疗性血浆置换（TPE）和利巴韦林治疗（简称 TPE 组），其余患者仅接受了利巴韦林治疗（简称非 TPE 组）。对临床和实验室参数进行了回顾性分析：结果显示，在接受 TPE 和利巴韦林治疗后，多种实验室指标均有明显改善，包括白细胞和中性粒细胞计数、乳酸脱氢酶、肌酸激酶同工酶-MB、凝血酶原时间、活化部分凝血活酶时间、D-二聚体、血清钠和病毒基因组拷贝数。TPE与利巴韦林联合治疗可显著降低死亡率，TPE组的死亡率为20.0%，而非TPE组的死亡率为40.4%（P = 0.033）：我们的研究结果表明，接受 TPE 和利巴韦林治疗的 SFTS 重症患者的临床和实验室指标均有所改善。这些结果表明，TPE 联合利巴韦林可能是治疗 SFTS 重症患者的一种很有前景的新型治疗方法。不过，还需要进行大样本量的比较研究或随机临床试验，以确认这种联合疗法在治疗重症 SFTS 病例中的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.