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Plasma exchange therapy for the post COVID-19 condition: a phase II, double-blind, placebo-controlled, randomized trial

Author

Listed:
  • Sergio España-Cueto

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC))

  • Cora Loste

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC)
    Red Española de Investigación en Covid Persistente (REICOP))

  • Gemma Lladós

    (Spain. Fundació Lluita contra les infeccions
    Red Española de Investigación en Covid Persistente (REICOP)
    Universitat Autònoma de Barcelona)

  • Cristina López

    (Spain. Fundació Lluita contra les infeccions)

  • José Ramón Santos

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC))

  • Gemma Dulsat

    (Spain. Fundació Lluita contra les infeccions)

  • Anna García

    (Spain. Fundació Lluita contra les infeccions)

  • João Carmezim

    (Germans Trias i Pujol Research Institute and Hospital (IGTP))

  • Julia Carabia

    (Spain. Fundació Lluita contra les infeccions)

  • Águeda Ancochea

    (Hospital Universitari Germans Trias i Pujol)

  • Carla Fernández-Prendres

    (Hospital Universitari Germans Trias i Pujol)

  • Cristian Morales-Indiano

    (Hospital Universitari Germans Trias i Pujol)

  • Bibiana Quirant

    (Universitat Autònoma de Barcelona
    Hospital Universitari Germans Trias i Pujol)

  • Eva Martínez-Cáceres

    (Universitat Autònoma de Barcelona
    Hospital Universitari Germans Trias i Pujol)

  • Anna Sanchez

    (Hospital Universitari Germans Trias i Pujol)

  • Ivonne Graciela Parraga

    (Hospital Universitari Germans Trias i Pujol)

  • Anna Chamorro

    (Spain. Fundació Lluita contra les infeccions)

  • Alba San José

    (Spain. Fundació Lluita contra les infeccions)

  • Elena Abad

    (Spain. Fundació Lluita contra les infeccions)

  • Jose A. Muñoz-Moreno

    (Spain. Fundació Lluita contra les infeccions
    Red Española de Investigación en Covid Persistente (REICOP)
    Universitat Oberta de Catalunya (UOC))

  • Anna Prats

    (Spain. Fundació Lluita contra les infeccions
    Red Española de Investigación en Covid Persistente (REICOP))

  • Carmina R. Fumaz

    (Spain. Fundació Lluita contra les infeccions
    Red Española de Investigación en Covid Persistente (REICOP))

  • Roser Coll-Fernández

    (Red Española de Investigación en Covid Persistente (REICOP)
    Rehabilitation Department. Hospital Universitari Germans Trias i Pujol)

  • Carla Estany

    (Spain. Fundació Lluita contra les infeccions)

  • Pamela Torrano

    (Spain. Fundació Lluita contra les infeccions
    Universitat Autònoma de Barcelona)

  • Jordi Puig

    (Spain. Fundació Lluita contra les infeccions
    Universitat Autònoma de Barcelona)

  • Bonaventura Clotet

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC)
    Universitat Autònoma de Barcelona
    IrsiCaixa)

  • Cristian Tebé

    (Germans Trias i Pujol Research Institute and Hospital (IGTP))

  • Marta Massanella

    (Red Española de Investigación en Covid Persistente (REICOP)
    IrsiCaixa
    Instituto de Salud Carlos III)

  • Roger Paredes

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC)
    IrsiCaixa
    Instituto de Salud Carlos III)

  • Lourdes Mateu

    (Spain. Fundació Lluita contra les infeccions
    University of Vic–Central University of Catalonia (UVic-UCC)
    Red Española de Investigación en Covid Persistente (REICOP)
    Universitat Autònoma de Barcelona)

Abstract

The post-COVID-19 condition (PCC) is a highly debilitating and persistent postinfectious syndrome that affects millions of people worldwide and has no effective treatment. Therapeutic plasma exchange (TPE) has the potential to improve the PCC by clearing the peripheral soluble pro-inflammatory immune milieu derived from acute or persistent SARS-CoV-2 infection. In a phase II, double-blind, placebo-controlled, randomized trial, fifty subjects with PCC were randomly assigned (1:1) to receive six sessions of either TPE or a sham plasma exchange and were followed for 90 days (ClinicalTrials.gov registration: NCT05445674). The primary endpoint was safety; secondary endpoints included functional status, symptomology, quality of life, neurocognitive symptoms, and peripheral biochemistry, hematology, coagulation and inflammation parameters. Both study arms had a similarly favorable safety profile. There were no diferences between groups in any of the efficacy parameters evaluated. Whereas TPE is safe, it did not lead to any discernible improvement of the PCC in this clinical trial.

Suggested Citation

  • Sergio España-Cueto & Cora Loste & Gemma Lladós & Cristina López & José Ramón Santos & Gemma Dulsat & Anna García & João Carmezim & Julia Carabia & Águeda Ancochea & Carla Fernández-Prendres & Cristia, 2025. "Plasma exchange therapy for the post COVID-19 condition: a phase II, double-blind, placebo-controlled, randomized trial," Nature Communications, Nature, vol. 16(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57198-7
    DOI: 10.1038/s41467-025-57198-7
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    References listed on IDEAS

    as
    1. Jon Klein & Jamie Wood & Jillian R. Jaycox & Rahul M. Dhodapkar & Peiwen Lu & Jeff R. Gehlhausen & Alexandra Tabachnikova & Kerrie Greene & Laura Tabacof & Amyn A. Malik & Valter Silva Monteiro & Juli, 2023. "Distinguishing features of long COVID identified through immune profiling," Nature, Nature, vol. 623(7985), pages 139-148, November.
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