Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 25, 2025 5 hours, 19 minutes ago
COVID-19 News: Understanding a Silent Killer in COVID-19
COVID-19 is not only a respiratory illness but also a disease that can damage blood vessels, leading to a dangerous condition known as thrombotic microangiopathy (TMA). This condition, which includes disorders like thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS), causes small blood clots that block circulation in vital organs such as the lungs and kidneys. The study, conducted by researchers from Stanford University Department of Pathology in the United States, Kansas City University of Medicine and Biosciences in Missouri, and the University of Miami Miller School of Medicine in Florida, sheds light on how plasma exchange therapy might help patients with severe COVID-19 complications. In this
Medical News report, the findings are explained in simple terms for everyone to understand.
Plasma Exchange Emerges as Hope for COVID-19 Microangiopathy
How COVID-19 Triggers Microangiopathy
When the SARS-CoV-2 virus attacks, it damages the thin layer of cells that line blood vessels, known as the endothelium. This injury sets off a dangerous chain reaction. The immune system floods the body with inflammatory chemicals called cytokines, leading to what doctors call a “cytokine storm.” At the same time, a natural defense system known as the complement system becomes overactive, causing further injury and tiny clots in the blood vessels.
Researchers also found that COVID-19 upsets the balance between two important blood proteins: von Willebrand factor (VWF), which helps blood clot, and ADAMTS13, which prevents excessive clotting. When VWF levels rise and ADAMTS13 drops, clots form unchecked, clogging small vessels in the lungs, kidneys, brain, and heart. These clots can cause organ failure and are often linked to the worst outcomes in critical patients.
Plasma Exchange Therapy as a Possible Solution
Therapeutic plasma exchange (TPE) is a medical procedure where a patient’s plasma, the liquid part of the blood, is removed and replaced with healthy plasma or a plasma substitute. This method can filter out harmful substances such as inflammatory cytokines, immune complexes, and clot-promoting proteins.
The study reviewed several patient cases where plasma exchange was used in severe COVID-19 with TMA. In many of these cases, patients showed improved oxygen levels, recovery of kidney function, stabilization of platelets, and even reversal of organ failure. Some patients who did not respond to conventional treatments improved quickly after undergoing plasma exchange. Importantly, combining TPE with other therapies like steroids, immunoglobulins, or complement inhibitors seemed to provide the best outcomes.
Why More Research Is Needed
While the early evidence is encouraging, scientists caution that plasma exchange is not yet a guaranteed cure. Most of the data so far comes from small studies or individual patient cases. Large, carefully controlled clinical trials are still needed to confirm who will benefit the m
ost, when the treatment should be started, and how it should be combined with other therapies. Moreover, plasma exchange is a resource-intensive procedure, which may not be easily available in every hospital setting.
A Potential Lifeline for Critical Patients
The findings suggest that plasma exchange could play a critical role in saving the lives of patients with severe COVID-19 microangiopathy. By reducing inflammation, balancing clotting factors, and protecting organs from further damage, this therapy may become an essential option for doctors treating the sickest patients. However, its widespread use will depend on stronger scientific evidence and availability of resources.
The study findings were published in the peer reviewed journal: Hematology, Transfusion and Cell Therapy.
https://www.sciencedirect.com/science/article/pii/S2531137925002317
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Medical News.
Read Also:
https://www.thailandmedical.news/news/covid-19-causes-morphological-changes-of-red-blood-cells-leading-to-microangiopathy-microthrombosis-impaired-blood-flow-tissue-oxygenation
https://www.thailandmedical.news/news/covid-19-damages-human-blood-vessels
https://www.thailandmedical.news/news/extracellular-histones-and-procoagulant-extracellular-vesicles-drive-the-prothrombotic-state-in-covid-19
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