Impact of Covid-19 on the therapeutic plasma exchange service within the South East Asian region: Consensus recommendations and global perspectives

Viswanathan S 1 , Hiew FL 1 , Siritho S 2 , Apiwattanakul M 3 , Tan K 4 , Quek AML 5 Show all authors , Estiasari R 6 , Remli R 7 , Bhaskar S 8 , Islam BM 9 , Aye SMM 10 , Ohnmar O 11 , Umapathi T 4 , Keosodsay SS 12 , Hoang NTT 13 , Yeo T 4 , Pasco PM 14

Affiliations 

  • 1 Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 2 Department of Neurology, Bumrungrad International Hospital and Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 3 Department of Neurology, Neurological Institute of Thailand, Bangkok, Thailand
  • 4 Department of Neurology, National Neuroscience Institute, Singapore
  • 5 Division of Neurology, Department of Medicine, National University Health System, Singapore
  • 6 Department of Neurology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • 7 Department of Neurology, National University of Malaysia, Kuala Lumpur, Malaysia
  • 8 Department of Medicine, Universiti Teknologi MARA, Sg Buloh, Selangor, Malaysia
  • 9 Department of Laboratory Sciences and Services Division, The International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
  • 10 Department of Neurology, Aryu International Hospital, Yangon, Myanmar
  • 11 Department of Neurology, Yangon General Hospital, Yangon, Myanmar
  • 12 Department of Neurology, Laos General Hospital, Vientiane, Laos
  • 13 Department of Neurology, Military Hospital 175, Ho Chi Minh City, Vietnam
  • 14 Department of Neurosciences, Philippine General Hospital, Manila, Philippines
J Clin Apher, 2021 Dec;36(6):849-863.
PMID: 34694652 DOI: 10.1002/jca.21937

Abstract

INTRODUCTION: Therapeutic plasma exchange (TPE) for neuroimmunological disorders has played an increasingly important role within the Southeast Asian (SEA) region. The South East Asian Therapeutic Plasma exchange Consortium (SEATPEC) was formed in 2018 to promote education and research on TPE within the region. The advent of the Covid-19 pandemic has produced challenges for the development and expansion of this service.

METHODOLOGY: A qualitative and semi-quantitative questionnaire-based survey was conducted by SEATPEC member countries from January to June 2020 (Phase 1) and then from July 2020 to January 2021 in (Phase 2) to assess the impact of Covid-19 on regional TPE.

OBJECTIVES: The study's main objectives were to explore the challenges experienced and adaptations/adjustments taken by SEATPEC countries in order to continue safe and efficient TPE during the Covid-19 pandemic.

RESULTS: The pandemic was found to disrupt the delivery of TPE services in all SEATPEC countries. Contributing factors were multifactorial due to overstretched medical services, staff shortages, quarantines and redeployments, fear of acquiring Covid-19, movement restriction orders, and patient's psychological fear of attending hospitals/testing for Covid-19. All SEATPEC countries practiced careful stratification of cases for TPE (electives vs emergencies, Covid-19 vs non-Covid-19 cases). SEATPEC countries had to modify TPE treatment protocols to include careful preprocedure screening of patient's for Covid-19, use of personal protective equipment (PPE) and post-TPE sanitization of machines and TPE suites.

CONCLUSION: Based on the responses of the survey, SEATPEC countries produced a consensus statement with five recommendations for safe and effective TPE within the region.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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