AUTOLOGOUS ACTIVATED PLATELET-RICH PLASMA (aaPRP) AS POTENTIAL THERAPY FOR SEVERE COVID-19 PATIENTS WITH THROMBOCYTOPENIA
Abstract
One of the coronavirus disease 2019 (COVID-19) effects in severe level was acute respiratory distress syndrome (ARDS) caused
by cytokine storm. The effective treatments of current COVID-19 therapies are still being evaluated; thus, it is necessary to find
new therapies to reduce cytokine storm. Platelets contain more than 1,000 bioactive molecules including anti-inflammatory
cytokines that could help in the improvement of COVID-19 patients. However, some patients who were infected by COVID-19
had low level of platelets (thrombocytopenia), lead the safety of therapy based on platelets should be evaluated. This study aimed
to evaluate the safety and efficacy of autologous activated platelet-rich plasma (aaPRP) treatment to thrombocytopenia patients
who were infected by COVID-19. A total of two patients of severe COVID-19 who confirmed with thrombocytopenia from Koja
Regional Public Hospital (Koja RPH) were admitted to the intensive care unit (ICU) and received aaPRP intravenously for three
times (day 1, 3 and 5). Patients were monitored during hospitalization including length of stay, the need of oxygen, and time of
recovery. All laboratory data including haematology and CRP level were recorded. Cytokine level of pro- and anti-inflammatory
markers including interleukin (IL) 4, 6, 10 and TNF alpha were measured. Chest X-ray data were evaluated. The results showed
that both of patients were recovered and discharged from hospital in good condition in less than two weeks of care. In the last
laboratory checkup data, one patient had normal thrombocyte level while the other slightly increased. All oxygen saturation was
increased into normal range parallel with the improvement of chest X-ray findings. The cytokine level of IL4 and IL6 were in the
normal range, while IL10 and TNF alpha were in elevated level until patients were discharged. Based on the results, it can be
concluded that aaPRP treatment is safe and potential to apply in COVID-19 patient even if the patient has less concentration of
thrombocytes.