Efficacy of Hemoperfusion in severe and critical cases of covid-19
Dr. Hajiesmaeili's latest paper was published in Research Square.
Introduction
In critically ill COVID-19 patients, uncontrolled over-production of inflammatory mediators is observed, dominantly. The excessive immune response give rise to multiple organ dysfunction. Implementing extracorporeal therapies may be useful in omitting inflammatory mediators and supporting different organ systems. We aimed to investigate the effectiveness of hemoperfusion in combination with standard therapy in critically ill COVID-19 patients.
Method
We conducted a single-center, matched control retrospective study on patients with confirmed SARS-CoV-2 infection. Patients were treated with hemoperfusion in combination with standard therapy (hemoperfusion group) or standard treatment (matched group). Hemoperfusion or hemoperfusion and CRRT (continuous renal replacement therapy) therapies were initiated in hemoperfusion group. The patients in the matched group were matched one by one with the hemoperfusion group for age, sex, the oxygen saturation (SPO2) at the admission and the frequency of using invasive mechanical ventilation during hospitalization. Two types of hemoperfusion cartridges used in this study were Jafron© (HA330) or cytosorb® 300.
Result
A total number of 128 COVID- 19 confirmed patients were enrolled in this study; 73 patients were allotted to the matched group and 55 patients received hemoperfusion. The median SPO2 at the admission in control and hemoperfusion groups was 80% and 75%, respectively (P-value=0.113). The mortality rate was significantly lower in hemoperfusion group compared to the matched group (67.3% vs. 89%; P.value=0.002). The median length of ICU stay was statistically different in studied groups (median, 12 days for hemoperfusion group vs. 8 days for the matched group; P<0.001). The median of final oxygen saturation was statistically higher and median of PaCO2 was lower in hemoperfusion group compared to the matched group.
Conclusion
Among critically ill COVID-19 patients, the use of hemoperfusion reduces the mortality rate and improves oxygen saturation and PaCO2.