The efficacy of plasma exchange in covid-19 patients with comorbid diabetes mellitus

Abstract

Objective: To explore the use of therapeutic plasma exchange as adjunctive therapy in COVID-19 patients with and without diabetes mellitus. Study Design: Prospective, observational study. Place and Duration of Study: Pakistan Emirates Military Hospital Rawalpindi, from Jan to Feb 2021. Methodology: A total of 90 male patients with laboratory-confirmed coronavirus infection were selected based on our inclusion criteria and their management and outcomes were recorded. The data were analyzed using SPSS-22 and Microsoft Excel. Results: The mortality rate was lower in patients who received 1 or more sessions of plasma exchange compared to those who did not receive plasma exchange (7.5% vs 12%). A lower mortality rate was seen in patients without diabetes who received therapeutic plasma exchange in addition to standard therapy compared to patients who received standard therapy alone (0 vs 14.82%, p=0.112). In patients with diabetes, a higher mortality rate was found in the group that had received therapeutic plasma exchange in addition to standard therapy instead of standard therapy alone (20% vs 8.7%, p=0.365). Conclusion: Overall our study supports the use of therapeutic plasma exchange in COVID-19 patients. However, although statistically insignificant, there appears to be a higher mortality rate in patients with diabetes who received therapeutic plasma exchange in addition to standard therapy. As such, we recommend further investigation of this aspect.