Efficacy of hemoadsorptions in the severe course of COVID-19

Aleksei Yurievitch Yakovlev ¹ Yuri Vladimirovitch Ilyin ¹ Feodor Feodorovitch Bershadsky ¹ Dmitry Dmitrievitch Selivanov ¹ Aleksei Aleksandrovitch Pevnev ¹ Artur Igorevitch Tricole ¹ Aleksander Yurievitch Popov ² Vladimir Mitrofanovich Pisarev ^3*

• ¹ Semashko N.A. Nizhegorodsky Regional Clinical Hospital, Nizhny Novgorod, Russia
• ² Nesmeyanov Institute of Organoelement Compounds of Russian Academy of Sciences (INEOS RAS), Moscow, Russia
• ³ V.A.Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitation, Moscow, Russia, Moscow, Russia

Introduction. Insufficiencies of majority targeted therapies for most severe, life-threatening forms of COVID-19 warrants alternative, adjuvant treatment options for the enhanced life maintenance that include extracorporeal blood purification and homeostasis support. The goal of current study is to evaluate the clinical efficacy of hemoadsorption with mesoporous hypercrosslinked polystyrene beads (Efferon CT single-use cartridge) in an expanded cohort of patients with the severe and critical COVID-19 resistant to antibody therapies and requiring post-therapy invasive mechanical lung ventilation (MLV) versus parameters-matched control group with no hemoadsorption. Materials and methods. A single-center cohort study (NCT06402279) enrolled patients from October 2020 to February 2022. The Efferon CT group (non-responders to anti-cytokine antibody therapy requiring IMV, hemadsorption and standard treatment, n=65) and retrospectively acquired propensity-matched control group (no hemadsorption, standard treatment only, n=65). Results. This observational study revealed the capability of Efferon CT hemoadsorption to safely, rapidly and significantly reduce the need for norepinephrine, increase the oxygenation index, prevent the sepsis-associated AKI, decrease the development of multiorgan failure and restore the immune system balance by decreasing proinflammatory IL-6, ferritin levels and neutrophil-to-lymphocyte ratio. Conclusions. The clinical efficiency of hemoadsorption using Efferon CT was confirmed by resolution of acute respiratory failure in 54% of patients, significantly increased the number of days without mechanical ventilation, early increasing the index of oxygenation. Most importantly, the hemoadsorption with Efferon CT was safe and resulted in significant decreasing the mortality in severe COVID-19 patients.