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Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19).
Asgharpour, Masoumeh; Mehdinezhad, Hamed; Bayani, Masoumeh; Zavareh, Mahmoud Sadeghi Haddad; Hamidi, Seyed Hossein; Akbari, Roghayeh; Ghadimi, Reza; Bijani, Ali; Mouodi, Simin.
  • Asgharpour M; Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
  • Mehdinezhad H; Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
  • Bayani M; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Zavareh MSH; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Hamidi SH; Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
  • Akbari R; Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.
  • Ghadimi R; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran.
  • Bijani A; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran.
  • Mouodi S; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran. dr.mouodi@gmail.com.
BMC Nephrol ; 21(1): 356, 2020 08 20.
Article in English | MEDLINE | ID: covidwho-723982
ABSTRACT

BACKGROUND:

Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines.

METHODS:

This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH).

RESULTS:

Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them (p < 0.001). Serum IL-6 showed a reduction from 139.70 ± 105.62 to 72.06 ± 65.87 pg/mL (p = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L (P = 0.016).

CONCLUSIONS:

Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients. TRIAL REGISTRATION The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2 .
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Hemofiltration / Renal Replacement Therapy / Coronavirus Infections / Extracorporeal Circulation / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMC Nephrol Journal subject: Nephrology Year: 2020 Document Type: Article Affiliation country: S12882-020-02020-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Hemofiltration / Renal Replacement Therapy / Coronavirus Infections / Extracorporeal Circulation / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMC Nephrol Journal subject: Nephrology Year: 2020 Document Type: Article Affiliation country: S12882-020-02020-3