Introduction. Plasmapheresis is a method of exchange blood plasma used in different categories of patients. Autoimmune diseases are prior to indications according to international guidelines for plasmapheresis. On the other hand, critical patients who determine cytokine disturbances due to Systemic inflammatory response does not represent a prior indication for plasmapheresis in guidelines. The aim of the study. Assessment of plasmapheresis in critical ill patients in ICU, who developed Severe Inflammatory Response with cytokine disturbances. Material and methods. A retrospective observational study of 64 medical records of patients admitted to ICU with sever COVID-19 was realized. Were recorded general data, and hemogram before plasmapheresis, and after plasmaphesis. Results. Plasmapheresis, performed in patients with severe COVID-19, SARS-CoV2 improved the clinical status and hemogram where Leukocytes, PCR, ferritin and lymphocytes denote a favorable evolution of cytokine disturbances and inflammatory response. C-reactive protein was evaluated, which decreases in 57% cases. C-reactive protein indicator, was correlated with patients hemodynamic and respiratory status improvement in 48% cases, after the plasmapheresis procedure. Patients that received plasmapheresis marked an improvement in serum ferritin index, in 70% cases. Analogously, the level of lymphocytes increased after the plasmapheresis in 55% cases. Conclusions. Severe COVID-19 (SARS-CoV-2) patients that were under plasmapheresis determined an improvement of Severe inflammatory response and Cytokine activity. Moreover, the performance of the procedure over the proinflammatory indices could suggest reconsider plasmapheresis as a prior procedure for sever COVID-19.