Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients That Required Continuous Renal Replacement Therapy With and Without Adjuvant Blood Purification

Background: oXiris use received EUA by the FDA as a blood purification adjuvant for COVID-19 critical illness. We evaluated clinical characteristics and outcomes of patients with COVID-19 critical illness that received CRRT with vs. without oXiris. Method(s): Single-center, retrospective cohort study of adult ICU patients with COVID-19 critical illness requiring CRRT (3/2020 to 4/2021). oXiris exposure was defined as a minimum use of 48 h within the first 72 h of CRRT initiation and use of at least 50% of time if the patient died within the first 72 h of CRRT. Data were analyzed with and without propensity-score (PS) matching and with PS-regression. Result(s): 114 critically ill COVID adults admitted to the ICU required CRRT during the study period. Of these, 11 patients used oXiris without meeting the definition of exposure and were excluded. Of the 103 remaining patients, 31 used oXiris and 72 did not. Mean (SD) age of the cohort was 60 (12) years, 66% were male, and 81% white. There were no differences in demographics between both groups. Similarly, there was no difference in baseline kidney function or prevalence of ESRD. Patients that received oXiris had more frequently sepsis (90% vs. 63%, p=0.004) and more frequently received IL-6 inhibitors but CRRT indications were similar in both groups, being the most common one fluid overload in about two-third of patients. Critical illness parameters including SOFA scores (median of 11 in both groups) and extracorporeal organ support (ECMO or mechanical ventilation) were also similar in both groups. Inpatient mortality was not different between both groups (74% in the oXiris group vs. 65% in the non-oXiris group, p=0.37). Further, 28-day ventilator, CRRT and ICU free-days were comparable in both groups. Similarly, kidney recovery rates were not different based on oXiris exposure. These results were consistent in all adjusted analyses. There were no circuit or filter related complications attributed to oXiris. Conclusion(s): The use of oXiris as adjuvant treatment of blood purification during CRRT appears feasible and safe. We did not observe differences in mortality, kidney recovery, or resource utilization among patients exposed vs. non-exposed to oXiris. The clinical impact of oXiris needs to be further evaluated in interventional studies.

A Key Action Plan for EDUCATION in a Global Crisis

Wars and natural disasters cause profound disturbances in human lives and social services. Historically, large pandemics have hit communities triggering rapid transformation of societies. The global COVID-19 outbreak has definitively challenged the world in an unprecedented way. Despite disruption of industry, trade, education, and social services due to prolonged home confinements, online activities have experienced an extraordinary revival. Lockdowns and social distancing have strongly penalized education programs based on classrooms face-to-face learning. Most schools and universities were abruptly forced to stop in-person classes and defer exams, experiencing great disturbance. Upon the first weeks of silence, expectation, and chaos, creative and innovative solutions were unfolded. They partially mitigated and fixed many of the most important challenges risen by COVID-19 shutdowns and home confinement. Engagement with e-teaching rapidly adapted to diverse student needs. On the other site, home confinement awakened a huge interest for e-learning. Online education has been pushed to be first in line. Once consolidated, it will stay for the long run, replacing traditional face-to-face education and expanding it to a much wider student population, ready to enjoy its flexibility and convenience. However, other teaching and learning benefits derived from direct personal interactions could experience downsides and result in the lost of very valuable skills, including those linked to body language, emotional intelligence, and deep feelings. Planning actions to confront these new threats are urgently needed. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Impact of new coronavirus epidemics on HIV-infected patients

Since the first report of a cluster of pneumonia cases in Wuhan (China) at the end of 2019 due to a new airborne highly transmissible coronavirus known as SARS-CoV-2, large-scale spreading has rapidly become a global concern. Up to the end of February 2020, more than 85,000 cases had been confirmed worldwide, mostly in China, with more than 3,000 deaths. Figures are increasing on a daily basis, being unpredictable what will happen next. Table 1 summarizes figures for major outbreaks due to acute viral infections recorded during the past 50 years.