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1.
Blood Purif ; 50(3): 290-297, 2021.
Article in English | MEDLINE | ID: covidwho-1533118

ABSTRACT

The principles and use of plasmapheresis are often little understood by intensivists. We propose to review the principles, the main indications, and the methods of using this technique.


Subject(s)
Critical Care/methods , Plasma Exchange/methods , Animals , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/therapy , COVID-19/therapy , Equipment Design , Guillain-Barre Syndrome/therapy , Humans , Liver Failure, Acute/therapy , Membranes, Artificial , Plasma Exchange/instrumentation , Purpura, Thrombotic Thrombocytopenic/therapy
3.
Biotechniques ; 71(4): 510-515, 2021 10.
Article in English | MEDLINE | ID: covidwho-1411518

ABSTRACT

Purity and integrity are two important criteria for any RNA extraction process to qualify the RNA for meaningful gene expression analysis. This study compares four commercially available RNA extraction kits using silica membrane and magnetic bead separation methods. The performance was evaluated in terms of both quantity (total RNA amount in µg/µl) and purity (260/280 ratio). The concentration and purity of each kit was significantly different from those of the others (p < 0.001). Although quantity obtained from Mag MAX is comparatively lower than QIAGEN, the quality is comparable as evident from real-time PCR performance. This study suggests that there are practical differences between these RNA extraction kits that should be taken into account while isolating RNA required for gene expression analysis.


Subject(s)
Magnets/chemistry , Membranes, Artificial , RNA, Viral/isolation & purification , Reagent Kits, Diagnostic , Silicon Dioxide/chemistry , COVID-19/diagnosis , COVID-19/virology , COVID-19 Nucleic Acid Testing/methods , Gene Expression Profiling/methods , Humans , Polymerase Chain Reaction/methods , RNA, Viral/genetics , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
4.
Rev Sci Instrum ; 92(7): 074101, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1338585

ABSTRACT

A fluid mechanics model of inhaled air gases, nitrogen (N2) and oxygen (O2) gases, and exhaled gas components (CO2 and water vapor particles) through a facial mask (membrane) to shield the COVID-19 virus is established. The model was developed based on several gas flux contributions that normally take place through membranes. Semiempirical solutions of the mathematical model were predicted for the N95 facial mask accounting on several parameters, such as a range of porosity size (i.e., 1-30 nm), void fraction (i.e., 10-3%-0.3%), and thickness of the membrane (i.e., 10-40 µm) in comparison to the size of the COVID-19 virus. A unitless number (Nr) was introduced for the first time to describe semiempirical solutions of O2, N2, and CO2 gases through the porous membrane. An optimum Nr of expressing the flow of the inhaled air gases, O2 and N2, through the porous membrane was determined (NO2 = NN2 = -4.4) when an N95 facial mask of specifications of a = 20 nm, l = 30 µm, and ε = 30% was used as a personal protection equipment (PPE). The concept of the optimum number Nr can be standardized not only for testing commercially available facial masks as PPEs but also for designing new masks for protecting humans from the COVID-19 virus.


Subject(s)
COVID-19/prevention & control , Masks , SARS-CoV-2 , Biomechanical Phenomena , Carbon Dioxide , Equipment Design , Exhalation , Gases , Humans , Hydrodynamics , Inhalation , Mathematical Concepts , Membranes, Artificial , Models, Theoretical , N95 Respirators , Nitrogen , Oxygen , Personal Protective Equipment , Porosity , Steam
6.
Blood Purif ; 51(1): 47-54, 2022.
Article in English | MEDLINE | ID: covidwho-1186414

ABSTRACT

INTRODUCTION: Uncontrolled systemic inflammation may occur in severe coronavirus disease 19 (COVID-19). We have previously shown that endotoxemia, presumably from the gut, may complicate COVID-19. However, the role of endotoxin adsorbent (EA) therapy to mitigate organ dysfunction in COVID-19 has not been explored. METHODS: We conducted a retrospective observational study in COVID-19 patients who received EA therapy at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between March 13 and April 17, 2020. Relevant clinical and laboratory data were collected by inpatient chart review. RESULTS: Among 147 hospitalized COVID-19 patients, 6 patients received EA therapy. All of the 6 patients had severe COVID-19 infection with acute respiratory distress syndrome (ARDS). Among these, 5 of them were mechanically ventilated and 4 had complications of secondary bacterial infection. The endotoxin activity assay (EAA) results of pre-EA therapy ranged from 0.47 to 2.79. The choices of EA therapy were at the discretion of attending physicians. One patient was treated with oXiris® along with continuous renal replacement therapy, and the others received polymyxin B hemoperfusion sessions. All patients have survived and were finally free from the mechanical ventilation as well as had improvement in PaO2/FiO2 ratio and decreased EAA level after EA therapy. CONCLUSIONS: We demonstrated the clinical improvement of severe COVID-19 patients with elevated EAA level upon receiving EA therapy. However, the benefit of EA therapy in COVID-19 ARDS is still unclear and needs to be elucidated with randomized controlled study.


Subject(s)
COVID-19/therapy , Endotoxemia/therapy , Hemoperfusion/methods , SARS-CoV-2 , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Adsorption , COVID-19/complications , Critical Care/methods , Endotoxemia/etiology , Female , Heparin/administration & dosage , Humans , Male , Membranes, Artificial , Middle Aged , Polymyxin B/administration & dosage , Renal Replacement Therapy , Respiratory Distress Syndrome/etiology , Retrospective Studies , Treatment Outcome
7.
ACS Appl Mater Interfaces ; 13(14): 16084-16096, 2021 Apr 14.
Article in English | MEDLINE | ID: covidwho-1164786

ABSTRACT

As COVID-19 exemplifies, respiratory diseases transmitted through aerosols or droplets are global threats to public health, and respiratory protection measures are essential first lines of infection prevention and control. However, common face masks are single use and can cause cross-infection due to the accumulated infectious pathogens. We developed salt-based formulations to coat membrane fibers to fabricate antimicrobial filters. Here, we report a mechanistic study on salt-induced pathogen inactivation. The salt recrystallization following aerosol exposure was characterized over time on sodium chloride (NaCl), potassium sulfate (K2SO4), and potassium chloride (KCl) powders and coatings, which revealed that NaCl and KCl start to recrystallize within 5 min and K2SO4 within 15 min. The inactivation kinetics observed for the H1N1 influenza virus and Klebsiella pneumoniae matched the salt recrystallization well, which was identified as the main destabilizing mechanism. Additionally, the salt-coated filters were prepared with different methods (with and without a vacuum process), which led to salt coatings with different morphologies for diverse applications. Finally, the salt-coated filters caused a loss of pathogen viability independent of transmission mode (aerosols or droplets), against both DI water and artificial saliva suspensions. Overall, these findings increase our understanding of the salt-recrystallization-based technology to develop highly versatile antimicrobial filters.


Subject(s)
Filtration/instrumentation , Influenza A Virus, H1N1 Subtype/drug effects , Klebsiella pneumoniae/drug effects , Masks , Potassium Chloride/chemistry , Sodium Chloride/chemistry , Sulfates/chemistry , Aerosols , Air Filters , Crystallization , Kinetics , Membranes, Artificial , Polypropylenes , Powders , Respiratory Protective Devices , Temperature , X-Ray Diffraction
8.
Anal Chem ; 93(4): 1957-1961, 2021 02 02.
Article in English | MEDLINE | ID: covidwho-1065765

ABSTRACT

This study introduces an innovative device for the noninvasive sampling and chromatographic analysis of different compounds present in exhaled breath aerosol (EBA). The new sampling device, especially in light of the recent COVID-19 pandemic that forced many countries to impose mandatory facemasks, allows an easy monitoring of the subject's exposure to different compounds they may come in contact with, actively or passively. The project combines the advantages of a fabric-phase sorptive membrane (FPSM) as an in vivo sampling device with a validated LC-MS/MS screening procedure able to monitor more than 739 chemicals with an overall analysis time of 18 min. The project involves the noninvasive in vivo sampling of the EBA using an FPSM array inserted inside an FFP2 mask. The study involved 15 healthy volunteers, and no restrictions were imposed during or prior to the sampling process regarding the consumption of drinks, food, or drugs. The FPSM array-LC-MS/MS approach allowed us to effectively exploit the advantages of the two complementary procedures (the convenient sampling by an FPSM array and the rapid analysis by LC-MS/MS), obtaining a powerful and green tool to carry out rapid screening analyses for human exposure to different compounds. The flexible fabric substrate, the sponge-like porous architecture of the high-efficiency sol-gel sorbent coating, the availability of a large cache of sorbent coatings, including polar, nonpolar, mixed mode, and zwitterionic phases, the easy installation into the facemask, and the possibility of sampling without interrupting regular activities provide FPSMs unparalleled advantages over other sampling techniques, and their applications are expected to expand to many other clinical or toxicological studies.


Subject(s)
Environmental Exposure , Membranes, Artificial , Textiles , COVID-19/epidemiology , COVID-19/virology , Chromatography, High Pressure Liquid/methods , Humans , Masks , Pandemics , Reproducibility of Results , SARS-CoV-2/isolation & purification , Tandem Mass Spectrometry/methods
9.
Stem Cells Transl Med ; 10(6): 883-894, 2021 06.
Article in English | MEDLINE | ID: covidwho-1060671

ABSTRACT

While mesenchymal stromal cells are an appealing therapeutic option for a range of clinical applications, their potential to induce clotting when used systemically remains a safety concern, particularly in hypercoagulable conditions, such as in patients with severe COVID-19, trauma, or cancers. Here, we tested a novel preclinical approach aimed at improving the safety of mesenchymal stromal cell (MSC) systemic administration by use of a bioreactor. In this system, MSCs are seeded on the exterior of a hollow-fiber filter, sequestering them behind a hemocompatible semipermeable membrane with defined pore-size and permeability to allow for a molecularly defined cross talk between the therapeutic cells and the whole blood environment, including blood cells and signaling molecules. The potential for these bioreactor MSCs to induce clots in coagulable plasma was compared against directly injected "free" MSCs, a model of systemic administration. Our results showed that restricting MSCs exposure to plasma via a bioreactor extends the time necessary for clot formation to occur when compared with "free" MSCs. Measurement of cell surface data indicates the presence of known clot inducing factors, namely tissue factor and phosphatidylserine. Results also showed that recovering cells and flushing the bioreactor prior to use further prolonged clot formation time. Furthermore, application of this technology in two in vivo models did not require additional heparin in fully anticoagulated experimental animals to maintain target activated clotting time levels relative to heparin anticoagulated controls. Taken together the clinical use of bioreactor housed MSCs could offer a novel method to control systemic MSC exposure and prolong clot formation time.


Subject(s)
Bioreactors , COVID-19/therapy , Cell Culture Techniques/methods , Mesenchymal Stem Cell Transplantation/methods , Thrombosis/prevention & control , Animals , Anticoagulants/pharmacology , Blood Coagulation Tests , Bone Marrow Cells/cytology , Cells, Cultured , Dogs , Heparin/pharmacology , Humans , Male , Membranes, Artificial , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/metabolism , Myocardial Infarction/pathology , Myocardial Infarction/prevention & control , SARS-CoV-2 , Swine
10.
Blood Purif ; 50(6): 921-924, 2021.
Article in English | MEDLINE | ID: covidwho-1030460

ABSTRACT

INTRODUCTION: Severe acute respiratory syndrome coronavirus-2 may lead to high levels of expression of inflammatory cytokines. Medium cut-off (MCO) membranes may make greater clearances for large-middle molecules (including cytokines) than low-flux (LF) membranes. In this study, we aimed to evaluate the impact of MCO membranes on outcome of COVID-19 patients on hemodialysis (HD). METHODS: Sixty COVID-19 HD patients were included in this study. The patients were categorized into 2 groups regarding type of HD membranes. Clinical data were taken from medical records. RESULTS: Initial crp and ferritin levels, which are surragates of cytokine storm and severity of disease in COVID-19, were significantly higher in MCO membrane group compared to LF group (p = 0.037 and 0.000, respectively). Although there were more patients with severe disease in MCO group, there were no significant differences regarding need for intensive care unit and death. CONCLUSION: It may be an option to use MCO membranes in HD patients with COVID-19 in order to reduce cytokine levels and prevent cytokine storm.


Subject(s)
COVID-19/therapy , Membranes, Artificial , Renal Dialysis/instrumentation , Aged , COVID-19/complications , Cytokine Release Syndrome/etiology , Cytokine Release Syndrome/therapy , Cytokines/isolation & purification , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification , Treatment Outcome
12.
Molecules ; 25(23)2020 Nov 26.
Article in English | MEDLINE | ID: covidwho-954930

ABSTRACT

Filtration systems used in technical and medical applications require components for fine particle deep filtration to be highly efficient and at the same time air permeable. In high efficiency filters, nonwoven meshes, which show increased performance based on small fiber diameters (e.g., using nanofibers), can be used as fine particle filter layers. Nanofiber nonwoven meshes made by electrospinning of spider silk proteins have been recently shown to exhibit required filter properties. Needle-based electrospinning, however, is limited regarding its productivity and scalability. Centrifugal electrospinning, in contrast, has been shown to allow manufacturing of ultrathin polymer nonwoven meshes in an efficient and scalable manner. Here, continuous roll-to-roll production of nonwoven meshes made of recombinant spider silk proteins is established using centrifugal electrospinning. The produced spider silk nanofiber meshes show high filter efficiency in the case of fine particulate matter below 2.5 µm (PM2.5) and a low pressure drop, resulting in excellent filter quality.


Subject(s)
Arthropod Proteins , Filtration , Membranes, Artificial , Nanofibers , Silk , Air Filters , Arthropod Proteins/chemistry , Filtration/methods , Nanofibers/ultrastructure , Spectrum Analysis
13.
Lab Chip ; 20(19): 3560-3568, 2020 10 07.
Article in English | MEDLINE | ID: covidwho-798864

ABSTRACT

A miniaturized polymerase chain reaction (PCR) system is not only important for medical applications in remote areas of developing countries, but also important for testing at ports of entry during global epidemics, such as the current outbreak of the coronavirus. Although there is a large number of PCR sensor systems available for this purpose, there is still a lack of portable digital PCR (dPCR) heating systems. Here, we first demonstrated a portable plasmonic heating-based dPCR system. The device has total dimensions of 9.7 × 5.6 × 4.1 cm and a total power consumption of 4.5 W, allowing for up to 25 dPCR experiments to be conducted on a single charge of a 20 000 mAh external battery. The dPCR system has a maximum heating rate of 10.7 °C s-1 and maximum cooling rate of 8 °C s-1. Target DNA concentrations in the range from 101 ± 1.4 copies per µL to 260 000 ± 20 000 copies per µL could be detected using a poly(dimethylsiloxane) (PDMS) microwell membrane with 22 080 well arrays (20 µm diameter). Furthermore, the heating system was demonstrated using a mass producible poly(methyl methacrylate) PMMA microwell array with 8100 microwell arrays (80 µm diameter). The PMMA microwell array could detect a concentration from 12 ± 0.7 copies per µL to 25 889 ± 737 copies per µL.


Subject(s)
Polymerase Chain Reaction/instrumentation , Algorithms , Biosensing Techniques , DNA/chemistry , Electric Power Supplies , Humans , Membranes, Artificial , Miniaturization , Polymethyl Methacrylate
14.
Artif Organs ; 44(12): 1296-1302, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-751817

ABSTRACT

Hypercytokines cause acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19) patients, which is the main reason for intensive care unit treatment and the leading cause of death in COVID-19 patients. Cytokine storm is a critical factor in the development of ARDS. This study evaluated the efficacy and safety of Oxiris filter in the treatment of COVID-19 patients. Five patients with COVID-19 who received continuous renal replacement therapy (CRRT) in Henan provincial people's hospital between January 23, 2019 and March 28, 2020, were enrolled in this study. Heart rate (HR), mean arterial pressure (MAP), oxygenation index (PaO2 /FiO2 ), renal function, C-reactive protein (CRP), cytokines, procalcitonin (PCT), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure score (SOFA), and prognosis were compared after CRRT. Five COVID-19 patients, three males and two females, aged 70.2 ± 19.6 years, were enrolled. After treatment, HR (101.4 ± 14.08 vs. 83.8 ± 6.22 bpm/min), CRP (183 ± 25.21 vs. 93.78 ± 70.81 mg/L), IL-6 (3234.49 (713.51, 16038.36) vs. 181.29 (82.24, 521.39) pg/mL), IL-8 (154.86 (63.97, 1476.1) vs. 67.19 (27.84, 85.57) pg/mL), and IL-10 (17.43 (9.14, 41.22) vs. 4.97 (2.39, 8.70) pg/mL), APACHE II (29 ± 4.92 vs. 18.4 ± 2.07), and SOFA (17.2 ± 1.92 vs. 11.2 ± 3.4) significantly decreased (P < .05), while MAP (75.8 ± 4.92 vs. 85.8 ± 6.18 mm Hg), and PaO2 /FiO2 (101.2 ± 7.49 vs. 132.6 ± 26.15 mm Hg) significantly increased (P < .05). Among the five patients, negative conversion of nucleic acid test was found in three cases, while two cases died. No adverse events occurred during the treatment. Our study observed a reduced level of overexpressed cytokines, stabilization of hemodynamic status, and staged improvement of organ function during the treatment with Oxiris filter.


Subject(s)
COVID-19/therapy , Continuous Renal Replacement Therapy/instrumentation , Cytokine Release Syndrome/prevention & control , Membranes, Artificial , Respiratory Distress Syndrome/prevention & control , APACHE , Adult , Aged , Aged, 80 and over , Blood Pressure , C-Reactive Protein/analysis , COVID-19/complications , Cytokine Release Syndrome/complications , Female , Heart Rate , Humans , Interleukins/blood , Male , Middle Aged , Organ Dysfunction Scores , Oxygen/blood , Respiratory Distress Syndrome/virology , Retrospective Studies
15.
Sci Rep ; 10(1): 13875, 2020 08 17.
Article in English | MEDLINE | ID: covidwho-720847

ABSTRACT

Respiratory protection is key in infection prevention of airborne diseases, as highlighted by the COVID-19 pandemic for instance. Conventional technologies have several drawbacks (i.e., cross-infection risk, filtration efficiency improvements limited by difficulty in breathing, and no safe reusability), which have yet to be addressed in a single device. Here, we report the development of a filter overcoming the major technical challenges of respiratory protective devices. Large-pore membranes, offering high breathability but low bacteria capture, were functionalized to have a uniform salt layer on the fibers. The salt-functionalized membranes achieved high filtration efficiency as opposed to the bare membrane, with differences of up to 48%, while maintaining high breathability (> 60% increase compared to commercial surgical masks even for the thickest salt filters tested). The salt-functionalized filters quickly killed Gram-positive and Gram-negative bacteria aerosols in vitro, with CFU reductions observed as early as within 5 min, and in vivo by causing structural damage due to salt recrystallization. The salt coatings retained the pathogen inactivation capability at harsh environmental conditions (37 °C and a relative humidity of 70%, 80% and 90%). Combination of these properties in one filter will lead to the production of an effective device, comprehensibly mitigating infection transmission globally.


Subject(s)
Air Filters/microbiology , Anti-Bacterial Agents/chemistry , Betacoronavirus , Coronavirus Infections/prevention & control , Masks/microbiology , Membranes, Artificial , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Respiratory Protective Devices/microbiology , Sodium Chloride/chemistry , Aerosols , Anti-Bacterial Agents/pharmacology , COVID-19 , Coronavirus Infections/transmission , Coronavirus Infections/virology , Crystallization , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Hot Temperature , Humans , Humidity , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Sodium Chloride/pharmacology
17.
Nephron ; 144(11): 550-554, 2020.
Article in English | MEDLINE | ID: covidwho-694591

ABSTRACT

The current pandemic of coronavirus disease 2019 (COVID-19) spotlighted the vulnerability of patients with chronic kidney disease stage 5 on maintenance hemodialysis (HD) to the viral infection. Social distancing is the most effective preventive measure to reduce the risk of infection. Nonetheless, the necessity to frequently reach the dialysis center and the inherent social gathering both impede social distancing and also self-quarantine for infected individuals. A baseline hyperinflammatory state driven by factors such as the retention of uremic toxins afflicts these patients. Concomitantly, a condition of relative immunosuppression is also attributed to similar factors. The use of high-flux (HF) dialyzers for HD is the standard of care. However, with HF membranes, the removal of large middle molecules is scant. Medium cutoff (MCO) dialyzers are a new class of membranes that allow substantial removal of large middle molecules with negligible albumin losses. Recent trials confirmed long-term safety and long-term sustained reduction in the concentration of large uremic toxins with MCO dialyzers. Herein, we discuss the rationale for applying MCO membranes in COVID-19 patients and its possible immunoadjuvant effects that could mitigate the burden of COVID-19 infection in dialysis patients. We also discuss the direct cytopathic effect of the virus on renal tissue and extracorporeal blood purification techniques that can prevent kidney damage or reduce acute kidney injury progression.


Subject(s)
Coronavirus Infections/complications , Kidney Failure, Chronic/therapy , Membranes, Artificial , Pneumonia, Viral/complications , Renal Replacement Therapy , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/physiopathology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2
18.
CEN Case Rep ; 9(4): 404-408, 2020 11.
Article in English | MEDLINE | ID: covidwho-603821

ABSTRACT

On 31 December 2019, cases of pneumonia whose cause was later identified as SARS-CoV-2 were detected in Wuhan City, Hubei Province of China, and now COVID-19 has spread worldwide. On March 1, 2020, a 69-year-old Japanese man who had been on hemodialysis for 3 years was diagnosed as having COVID-19 pneumonia and hospitalized at our Medical Center. Pulmonary CT revealed bilateral multiple consolidation with bilateral pleural effusion. Aggressive weight reduction was needed to improve the patient's respiratory condition. Hemodialysis therapy was performed in isolation with hydroxychloroquine administration, but the formation of a dialysis membrane clot forced the withdrawal of dialysis therapy. Changing the dialysis membrane material and anticoagulant enabled the resumption of dialysis therapy, allowing the body weight to correct downward. On the 5th hospitalization day, the patient's fever dropped and he showed improved oxygenation and chest X-ray. He was eventually discharged. The hydroxychloroquine and appropriate fluid management may have contributed to the patient's recovery. Clinicians should pay close attention to avoid dialysis-related problems when treating a patient with COVID-19.


Subject(s)
Coronavirus Infections , Hydroxychloroquine/administration & dosage , Kidney Failure, Chronic , Pandemics , Pleural Effusion , Pneumonia, Viral , Renal Dialysis , Aged , Anti-Infective Agents/administration & dosage , Anticoagulants/therapeutic use , COVID-19 , Combined Modality Therapy , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Humans , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Lung/diagnostic imaging , Male , Membranes, Artificial , Pleural Effusion/diagnosis , Pleural Effusion/etiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Renal Dialysis/instrumentation , Renal Dialysis/methods , Tomography, X-Ray Computed/methods , Treatment Outcome
19.
Blood Purif ; 50(2): 141-149, 2021.
Article in English | MEDLINE | ID: covidwho-423313

ABSTRACT

The real issue with the COVID-19 pandemic is that a rapidly increasing number of patients with life-threatening complications are admitted in hospitals and are not well-administered. Although a limited number of patients use the intensive care unit (ICU), they consume medical resources, safety equipment, and enormous equipment with little possibility of rapid recovery and ICU discharge. This work reviews effective methods of using filtration devices in treatment to reduce the level of various inflammatory mediators and discharge patients from the ICU faster. Extracorporeal technologies have been reviewed as a medical approach to absorb cytokines. Although these devices do not kill or remove the virus, they are a promising solution for treating patients and their faster removal from the ICU, thus relieving the bottleneck.


Subject(s)
COVID-19/complications , Cytokine Release Syndrome/therapy , Cytokines/blood , Hemofiltration/methods , SARS-CoV-2 , Shock, Septic/therapy , Sorption Detoxification/methods , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Anti-Bacterial Agents/therapeutic use , COVID-19/blood , Coated Materials, Biocompatible , Combined Modality Therapy , Continuous Renal Replacement Therapy , Cross-Over Studies , Cytokine Release Syndrome/blood , Cytokine Release Syndrome/etiology , Double-Blind Method , Equipment Design , Hemofiltration/instrumentation , Humans , Membranes, Artificial , Microspheres , Multiple Organ Failure/etiology , Multiple Organ Failure/therapy , Plasmapheresis/methods , Randomized Controlled Trials as Topic , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Shock, Septic/blood , Shock, Septic/etiology , Sorption Detoxification/instrumentation
20.
ACS Nano ; 14(6): 7659-7665, 2020 06 23.
Article in English | MEDLINE | ID: covidwho-324479

ABSTRACT

Since the outbreak of the severe respiratory disease caused by the novel coronavirus (COVID-19), the use of face masks has become ubiquitous worldwide to control the rapid spread of this pandemic. As a result, the world is currently facing a face mask shortage, and some countries have placed limits on the number of masks that can be bought by each person. Although the surgical grade N95 mask provides the highest level of protection currently available, its filtration efficiency for sub-300 nm particles is around 85% due to its wider pore size (∼300 nm). Because the COVID-19 virus shows a diameter of around 65-125 nm, there is a need for developing more efficient masks. To overcome these issues, we demonstrate the development of a flexible, nanoporous membrane to achieve a reusable N95 mask with a replaceable membrane and enhanced filtration efficiency. We first developed a flexible nanoporous Si-based template on a silicon-on-insulator wafer using KOH etching and then used the template as a hard mask during a reactive ion etching process to transfer the patterns onto a flexible and lightweight (<0.12 g) polymeric membrane. Pores with sizes down to 5 nm were achieved with a narrow distribution. Theoretical calculations show that airflow rates above 85 L/min are possible through the mask, which confirms its breathability over a wide range of pore sizes, densities, membrane thicknesses, and pressure drops. Finally, the membrane is intrinsically hydrophobic, which contributes to antifouling and self-cleaning as a result of droplets rolling and sliding on the inclined mask area.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Masks , Nanopores , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Air Microbiology , Betacoronavirus/ultrastructure , COVID-19 , Coronavirus Infections/transmission , Equipment Design , Humans , Hydrophobic and Hydrophilic Interactions , Membranes, Artificial , Microscopy, Electron, Scanning , Nanopores/ultrastructure , Pneumonia, Viral/transmission , Polymers , Porosity , SARS-CoV-2 , Silicon
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