There were no differences 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.
Nature Communications
Summary
- A study published in Nature Communications on February 24, 2025, tested whether plasma exchange therapy (TPE) could improve post-COVID-19 condition (PCC).
- The study was a phase II, double-blind, placebo-controlled, randomised trial involving 50 participants, who received either TPE or sham plasma exchange for six sessions, followed for 90 days.
- Both groups showed similarly favourable safety profiles, but no significant differences were found in efficacy outcomes.
- Dr Charles Shepherd, MEA Hon. Medical Advisor, comments, ‘The negative results cast further doubt as to whether apheresis, which is being promoted as a treatment for Long Covid in private clinics, is of any value.'
On the 24th February 2025, Nature Communications published the following paper titled, ‘Plasma exchange therapy for the post COVID-19 condition: a phase II, double-blind, placebo-controlled, randomized trial.'
Extracts
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 differences 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.
Dr Charles Shepherd Comments:
This is a small but well conducted clinical trial to assess whether plasma exchange is a safe and effective treatment for Long Covid.
The negative results cast further doubt as to whether apheresis, which is being promoted as a treatment for Long Covid in private clinics, is of any value.
Plasma exchange has also been assessed as a possible treatment for ME/CFS. See this Question and Answer from the MEA website Medical Matters library.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
