The use of therapeutic plasma exchange as adjunctive therapy in the treatment of coronavirus disease 2019: A critical appraisal of the current evidence.


Lu W(1), Kelley W(2)(3), Fang DC(4), Joshi S(5), Kim Y(6), Paroder M(7), Tanhehco Y(8), Tran MH(9), Pham HP(10).
Author information:
(1)Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
(2)American Red Cross, Salt Lake City, Utah, USA.
(3)Department of Pathology, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA.
(4)Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.
(5)Department of Hematology-Oncology, Seattle Children's Hospital, Seattle, WA, USA.
(6)Department of Transfusion Services, New York Presbyterian Queens, Flushing, New York, USA.
(7)Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
(8)Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA.
(9)Department of Pathology and Cell Biology, Irvine School of Medicine, University of California, Irving, California, USA.
(10)National Marrow Donor Program, Seattle, WA, USA.


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a major pandemic. While vaccine development moves forward, optimal treatment continues to be explored. Efforts include an ever-expanding number of clinical trials along with newly proposed experimental and off-label investigational therapies; one of which is therapeutic plasma exchange (TPE). There have been a number of publications on TPE use as adjunctive therapy for coronavirus disease 2019 (COVID-19), but no prospective randomized controlled trials (RCTs) have been completed. This article critically appraises the current available evidence on TPE as a treatment modality for SARS-CoV-2 infection.