Extracorporeal Blood Purification in Severe COVID-19

Severe COVID-19 is characterized by excessive and uncontrolled inflammation. In many severe cases, the hyperinflammatory response induced by COVID-19 is responsible for severity and death. In this study, the researchers studied the variation of parameters involved with systemic inflammation in critically ill COVID-19 patients upon extracorporeal blood purification.

The study involved 44 COVID-19 cases treated with the cycle extracorporeal continuous venovenous hemofiltration (CVVH) with cytokine adsorbing hemofilter (CAH). The AN 69ST (oXiris) cytokine adsorbing hemodiafilter was used here. This device can reduce cytokine levels and support hemodynamic stabilization. The severe 30 patients received CVVHF-CAH within 4-12 hours of hospitalization and the remaining 14 patients with mild-to-moderate symptoms progressed to severe disease and placed on extracorporeal blood purification (EBP). The treatment reduced the ferritin, fibrinogen, CRP, and several other inflammatory markers. Hematological parameters showed a continuous decline, the blood urea rose in the severe cohort.

Severe patients showed a gradual improvement in their low peripheral oxygen saturation and breathing capacity. A high bacterial co-infection count was noted in this study as compared to the previous study. The study results concluded that EBP improves the condition if patients associated with an observable reduction of numerous inflammatory markers, resolution of cytopenias, and acute-phase proteins.

Ref link: https://www.medrxiv.org/content/10.1101/2020.10.10.20210096v1