The Efficacy of Double Filtration Plasmapheresis in Severe Fever With Thrombocytopenia Syndrome: A Multicenter Retrospective Study.

INTRODUCTION: Double filtration plasmapheresis (DFPP) effectively removes toxins and inflammatory cytokines and is widely used for critical illnesses. However, evidence supporting DFPP use in severe fever with thrombocytopenia syndrome (SFTS) is scarce. METHODS: We enrolled 144 severe SFTS patients matched 1:1 into DFPP and control groups (72 patients per group). Baseline characteristics were balanced between groups. Oxygenation, hemodynamics, inflammatory cytokines, and clinical endpoints (ICU stay, ventilation duration, complications, ICU, and 30-day mortality) were compared. RESULTS: The two matched groups showed comparable baseline characteristics. DFPP improved oxygenation and hemodynamic indices, suppressed inflammatory cytokines, shortened ICU stay (13 (9-18) vs16 (12-23) days, p = 0.001), mechanical ventilation duration (8 (6-11) vs. 10 (7-13) days, p = 0.002), and lowered ICU mortality (9 (12.50) vs. 20 (27.78), p = 0.018) and 30-day mortality (p = 0.01). CONCLUSIONS: DFPP alleviates clinical manifestations and improves prognosis in patients with severe SFTS.