The spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic infection to respiratory failure and death of patients. Severely affected patients may develop a cytokine storm-like clinical syndrome with multi-organ failure and a mortality rate of up to 90%.

Recently, it has been suggested that plasma exchange (PE) may positively influence this unfavorable course.

Here we report on five COVID-19 patients with a median age of 67 years who were admitted to the medical intensive care unit of Heidelberg University Hospital due to respiratory failure.

Patients who had received at least one PE until May 15, 2020, were considered for analysis with clinical follow-up until June 15, 2020.

Prophylactic antibiotic (piperacillin/tazobactam), antimycotic (caspofungin), and antiviral/immunomodulatory therapy (hydroxychloroquine or maraviroc) was initiated in all patients upon admission according to center practice.

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