Description of Event or Problem · 1
THE ALBUMIN QUOTIENT WAS ELEVATED IN THREE OF FIVE PATIENTS, AND OGB WAS NEGATIVE IN ALL FIVE. THEREFORE, PLASMAPHERESIS WITH ALBUMIN WAS INITIATED AND PERFORMED ON ALTERNATE DAYS ON THE HYPOTHESIS OF AN AUTOIMMUNE CNS INVOLVEMENT FOR BOTH MRI POSITIVE AND NEGATIVE CASES. THERAPY IN CASE 5 CONTINUED IN THE ICU AFTER 5 CYCLES OF PLASMAPHERESIS FOR REACTIVATION OF CYTOMEGALOVIRUS INFECTION. HOW DIAGNOSIS WAS MADE: CLINICAL ASSESSMENT; IMAGING; PCR. WHY INFECTION IS DIFFICULT TO TREAT? THERE IS NO STANDARD/APPROVED THERAPY FOR THIS DISEASE; UNUSUAL DISEASE PRESENTATION. DRUGS USED IN NEW WAY: AZITHROMYCIN - TO TREAT A DISEASE OTHER THAN THE ONE FOR WHICH THE DRUG IS APPROVED; IN A NOVEL COMBINATION WITH ANOTHER DRUG HYDROXYCHLOROQUINE: TO TREAT A DISEASE OTHER THAN THE ONE FOR WHICH THE DRUG IS APPROVED; IN A NOVEL COMBINATION WITH ANOTHER DRUG FAVIPIRAVIR: TO TREAT A DISEASE OTHER THAN THE ONE FOR WHICH THE DRUG IS APPROVED; IN A NOVEL COMBINATION WITH ANOTHER DRUG PLASMAPHERESIS: TO TREAT A DISEASE OTHER THAN THE ONE FOR WHICH THE DRUG IS APPROVED; IN A NOVEL COMBINATION WITH ANOTHER DRUG. DRUG TREATMENT SETTING: AZITHROMYCIN: ICU/CRITICAL CARE. HYDROXYCHLOROQUINE: ICU/CRITICAL CARE. FAVIPIRAVIR: ICU/CRITICAL CARE. PLASMAPHERESIS: ICU/CRITICAL CARE. ABSTRACT: SEVERE SARS-COV-2 (COVID-19) INFECTION HAS THE POTENTIAL FOR A HIGH MORTALITY RATE. IN THIS PAPER, WE REPORT THE RESULTS OF PLASMAPHERESIS TREATMENT IN A SERIES OF SEVERELY ILL PATIENTS WITH COVID-19-RELATED AUTOIMMUNE MENINGOENCEPHALITIS IN THE INTENSIVE CARE UNIT (ICU).