AUTHOR=Virág Marcell , Rottler Máté , Ocskay Klementina , Leiner Tamás , Horváth Balázs , Blanco Daniel Adam , Vasquez Alexa , Bucsi László , Sárkány Ágnes , Molnár Zsolt 

TITLE=Extracorporeal Cytokine Removal in Critically Ill COVID-19 Patients: A Case Series

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.760435

DOI=10.3389/fmed.2021.760435

ISSN=2296-858X

ABSTRACT=<p><bold>Introduction:</bold> Extracorporeal hemoadsorption (HA) is a potential adjunctive therapy in severe cases of COVID-19 associated pneumonia. In this retrospective study we report data from critically ill patients treated with HA during the first and second wave of the pandemic.</p><p><bold>Patients and Methods:</bold> All patients, who received HA therapy with CytoSorb within the first 96 h of intensive care unit (ICU) admission without hospital-acquired bacterial superinfection, were included. Clinical and laboratory data were collected: on admission, before (T<sub>B</sub>) and after (T<sub>A</sub>) HA therapy.</p><p><bold>Results:</bold> Out of the 367 COVID-19 cases, 13 patients were treated with CytoSorb, also requiring mechanical ventilation and renal replacement therapy. All patients were alive at the end of HA, but only 3 survived hospital stay. From T<sub>B</sub>-T<sub>A</sub> there was a tendency of decreasing norepinephrine requirement: 193.7 [IQR: 34.8–270.4] to 50.2 [6.5–243.5] ug/kg/day and increasing PaO2/FiO2 ratio 127.8 (95% CI: 96.0–159.6) to 155.0 (115.3–194.6) mmHg but they did not reach statistical significance (<italic>p</italic> = 0.14 and 0.58, respectively). Treatment related adverse events were not reported.</p><p><bold>Conclusion:</bold> The treatment was well-tolerated, and there was a tendency toward an improvement in vasopressor need and oxygenation during the course of HA. These observations render the need for prospective randomized trials.</p>