Early Hemoperfusion for Cytokine Removal May Contribute to Prevention of Intubation in Patients Infected with COVID-19

Abstract

Hemoperfusion (HP) was helpful to prevent the development and progression of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), liver failure, and septic shock by removing cytokines and other inflammatory mediators and ultimately preventing progression toward multiple organ failure. A 54-year-old man diagnosed with COVID-19 was hospitalized in the intensive care unit. The patient's O2 saturation was 80% using an oxygen mask, which was gradually declining. After 4 sessions of HP/continuous renal replacement therapies (CRRT), O2 saturation reached to 95%, and the patient was transferred to the general ward. Performing HP/CRRT at the early stages of ARDS can obviate the need for intubating patients with COVID-19. Punctual and early use of HP and CRRT in the treatment of ARDS in patients with COVID-19 prevented the progression of ARDS and patient intubation, reduced respiratory distress and the patient's dependence on oxygen, prevented other complications such as AKI and septic shock in the patient, and reduced mortality and hospital length of stay.

Keywords: Acute respiratory distress syndrome; COVID-19; Continuous renal replacement therapy; Cytokine; Hemoperfusion.

Conflict of interest statement

CR consulted or advised in the last 3 years for ASAHI, Astute, Baxter, Biomerieux, B. Braun, Cytosorbents, ESTOR, FMC, GE, Jafron, Medtronic, and Toray. The other authors have no conflicts of interest.

© 2020 S. Karger AG, Basel.

Figures

Fig. 1

Patient's chest X-ray when admitted to the ICU.

Fig. 2

Patient's chest X-ray after session 2.

Fig. 3

Patient's chest X-ray in time of transfer from the ICU to the general ward.

Fig. 4

Hemoglobin saturation of the patient during the treatment period from admission to the intensive care unit until discharge.