Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series
Introduction: Extracorporeal hemoadsorption (HA) is a potential adjunctive therapy in severe cases of COVID-19 associated pneumonia. In this retrospective study we report data from critically ill patients treated with HA during the first and second wave of the pandemic.Patients and Methods: All pati...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:c91d1d25d4744c428e4340e37efbffa72021-11-19T05:16:30ZExtracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series2296-858X10.3389/fmed.2021.760435https://doaj.org/article/c91d1d25d4744c428e4340e37efbffa72021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.760435/fullhttps://doaj.org/toc/2296-858XIntroduction: Extracorporeal hemoadsorption (HA) is a potential adjunctive therapy in severe cases of COVID-19 associated pneumonia. In this retrospective study we report data from critically ill patients treated with HA during the first and second wave of the pandemic.Patients and Methods: All patients, who received HA therapy with CytoSorb within the first 96 h of intensive care unit (ICU) admission without hospital-acquired bacterial superinfection, were included. Clinical and laboratory data were collected: on admission, before (TB) and after (TA) HA therapy.Results: Out of the 367 COVID-19 cases, 13 patients were treated with CytoSorb, also requiring mechanical ventilation and renal replacement therapy. All patients were alive at the end of HA, but only 3 survived hospital stay. From TB-TA there was a tendency of decreasing norepinephrine requirement: 193.7 [IQR: 34.8–270.4] to 50.2 [6.5–243.5] ug/kg/day and increasing PaO2/FiO2 ratio 127.8 (95% CI: 96.0–159.6) to 155.0 (115.3–194.6) mmHg but they did not reach statistical significance (p = 0.14 and 0.58, respectively). Treatment related adverse events were not reported.Conclusion: The treatment was well-tolerated, and there was a tendency toward an improvement in vasopressor need and oxygenation during the course of HA. These observations render the need for prospective randomized trials.Marcell VirágMarcell VirágMarcell VirágMáté RottlerMáté RottlerMáté RottlerKlementina OcskayTamás LeinerTamás LeinerBalázs HorváthDaniel Adam BlancoAlexa VasquezLászló BucsiÁgnes SárkányZsolt MolnárZsolt MolnárZsolt MolnárZsolt MolnárZsolt MolnárFrontiers Media S.A.articleARDScytokine stormCRRTCOVID-19hemoadsorptionCytosorbMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021) |
| institution |
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| collection |
DOAJ |
| language |
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| topic |
ARDS cytokine storm CRRT COVID-19 hemoadsorption Cytosorb Medicine (General) R5-920 |
| spellingShingle |
ARDS cytokine storm CRRT COVID-19 hemoadsorption Cytosorb Medicine (General) R5-920 Marcell Virág Marcell Virág Marcell Virág Máté Rottler Máté Rottler Máté Rottler Klementina Ocskay Tamás Leiner Tamás Leiner Balázs Horváth Daniel Adam Blanco Alexa Vasquez László Bucsi Ágnes Sárkány Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| description |
Introduction: Extracorporeal hemoadsorption (HA) is a potential adjunctive therapy in severe cases of COVID-19 associated pneumonia. In this retrospective study we report data from critically ill patients treated with HA during the first and second wave of the pandemic.Patients and Methods: All patients, who received HA therapy with CytoSorb within the first 96 h of intensive care unit (ICU) admission without hospital-acquired bacterial superinfection, were included. Clinical and laboratory data were collected: on admission, before (TB) and after (TA) HA therapy.Results: Out of the 367 COVID-19 cases, 13 patients were treated with CytoSorb, also requiring mechanical ventilation and renal replacement therapy. All patients were alive at the end of HA, but only 3 survived hospital stay. From TB-TA there was a tendency of decreasing norepinephrine requirement: 193.7 [IQR: 34.8–270.4] to 50.2 [6.5–243.5] ug/kg/day and increasing PaO2/FiO2 ratio 127.8 (95% CI: 96.0–159.6) to 155.0 (115.3–194.6) mmHg but they did not reach statistical significance (p = 0.14 and 0.58, respectively). Treatment related adverse events were not reported.Conclusion: The treatment was well-tolerated, and there was a tendency toward an improvement in vasopressor need and oxygenation during the course of HA. These observations render the need for prospective randomized trials. |
| format |
article |
| author |
Marcell Virág Marcell Virág Marcell Virág Máté Rottler Máté Rottler Máté Rottler Klementina Ocskay Tamás Leiner Tamás Leiner Balázs Horváth Daniel Adam Blanco Alexa Vasquez László Bucsi Ágnes Sárkány Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár |
| author_facet |
Marcell Virág Marcell Virág Marcell Virág Máté Rottler Máté Rottler Máté Rottler Klementina Ocskay Tamás Leiner Tamás Leiner Balázs Horváth Daniel Adam Blanco Alexa Vasquez László Bucsi Ágnes Sárkány Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár Zsolt Molnár |
| author_sort |
Marcell Virág |
| title |
Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| title_short |
Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| title_full |
Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| title_fullStr |
Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| title_full_unstemmed |
Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series |
| title_sort |
extracorporeal cytokine removal in critically ill covid-19 patients: a case series |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/c91d1d25d4744c428e4340e37efbffa7 |
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