scholarly journals Extracorporeal Blood Purification in moderate and severe COVID-19 patients: a prospective cohort study

2020 ◽  
Author(s):  
Rodney Alexander Rosalia ◽  
Petar Ugurov ◽  
Dashurie Neziri ◽  
Simona Despotovska ◽  
Emilja Kostoska ◽  
...  
Keyword(s):  
Acute Phase Proteins ◽  
Severe Disease ◽  
Blood Purification ◽  
Blood Gas ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Extracorporeal Blood ◽  
Variation Of Parameters ◽  
Extracorporeal Blood Purification ◽  
Therapeutic Avenue

AbstractIntroductionCOVID-19 is characterised by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and critical cases progressing to ARDS. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation.With this work, we describe the longitudinal variation of parameters of systemic inflammation in critically ill COVID-19 patients treated with blood purification using AN69ST (oXiris®) hemodiafilter.MethodsWe performed a time-series analysis of 44 consecutive COVID-19 cases treated with the AN69ST (oXiris®) cytokine adsorbing hemodiafilter; we visualise longitudinal results of biochemical, inflammatory, blood gas- and vital sign parameters.ResultsBlood purification was indicated for suspected hyperinflammation or hypercoagulation, (= CRP ≥ 100 mg/L and/or IL-6 ≥ 40 pg/mL and/or Ferritin ≥ 500 ng/mL and/or Lactate Dehydrogenase > 365 U/L or D-dimers > 2000 ng/mL). All patients were treated with ≥ 1 cycle extracorporeal continuous venovenous hemofiltration (CVVHF) with cytokine adsorbing hemodiafilter (CAH); of these, 30 severe patients received CVVHF-CAH within 4 – 12 hours of hospitalisation. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and placed on EBP during the course of hospitalisation. The treatment was associated with a reduction of Ferritin, C-reactive protein, Fibrinogen, several inflammatory markers and a resolution of numerous cytopenias. The observed mortality across the cohort was 36.3% across the cohort.ConclusionExtracorporeal blood purification with cytokine adsorbing hemofilter was associated with a decrease in the acute phase proteins CRP, Ferritin, and resolution of numerous cytopenias. Repetitive hemofiltration has been associated with lower levels of IL-6 in COVID-19 patients.

scholarly journals Extracorporeal Blood Purification in Moderate and Severe COVID-19 Patients: A Prospective Cohort Study

2021 ◽  
pp. 1-10
Author(s):  
Rodney Alexander Rosalia ◽  
Petar Ugurov ◽  
Dashurie Neziri ◽  
Simona Despotovska ◽  
Emilija Kostoska ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Inflammatory Markers ◽  
Severe Disease ◽  
Blood Purification ◽  
Reactive Protein ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Continuous Venovenous Haemofiltration ◽  
Inflammatory State ◽  
And Control

<b><i>Introduction:</i></b> Coronavirus disease 2019 (COVID-19) is characterized by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and with critical cases progressing to acute respiratory distress syndrome. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation. With this work, we evaluated the longitudinal changes of systemic inflammatory markers in critically ill COVID-19 patients treated with blood purification using AN69ST (oXiris®) haemofilter. <b><i>Methods:</i></b> We performed a time-series analysis of 44 consecutive COVID-19 cases treated with the AN69ST (oXiris®) cytokine adsorbing haemofilter (CAH) according to local practice; we visualize longitudinal results of biochemical, inflammatory, blood gas, and vital sign parameters focussing on systemic levels of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin. <b><i>Results:</i></b> All patients were treated with ≥1 cycle extracorporeal continuous venovenous haemofiltration (CVVH) with CAH; of these, 30 severe patients received CVVH-CAH within 4–12 h of admission after recognizing a hyper-inflammatory state. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and were placed on EBP during hospitalization. The treatment was associated with a reduction of ferritin, CRP, fibrinogen, several inflammatory markers, and a resolution of numerous cytopenias. The observed mortality across the cohort was 36.3%. <b><i>Conclusion:</i></b> EBP with CAH was associated with a decrease in CRP, and control of IL-6 and procalcitonin.

scholarly journals Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Masoumeh Asgharpour ◽  
Hamed Mehdinezhad ◽  
Masoumeh Bayani ◽  
Mahmoud Sadeghi Haddad Zavareh ◽  
Seyed Hossein Hamidi ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Blood Purification ◽  
Medical Sciences ◽  
Therapeutic Approaches ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Beneficial Impact ◽  
Coronavirus Infection

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 increased 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.

scholarly journals Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Masoumeh Asgharpour ◽  
Hamed Mehdinezhad ◽  
Masoumeh Bayani ◽  
Mahmoud Sadeghi Haddad Zavareh ◽  
Seyed Hossein Hamidi ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Blood Purification ◽  
Medical Sciences ◽  
Therapeutic Approaches ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Beneficial Impact ◽  
Coronavirus Infection

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 increased 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.

scholarly journals Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Masoumeh Asgharpour ◽  
Hamed Mehdinezhad ◽  
Masoumeh Bayani ◽  
Mahmoud Sadeghi Haddad Zavareh ◽  
Seyed Hossein Hamidi ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Blood Purification ◽  
Medical Sciences ◽  
Therapeutic Approaches ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Extracorporeal Blood Purification ◽  
Reference Number ◽  
Beneficial Impact ◽  
Coronavirus Infection

Abstract BackgroundExtracorporeal 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. MethodsThis 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). ResultsFive 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).ConclusionsExtracorporeal 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 registrationThe research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2.

scholarly journals Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2077
Author(s):  
Yi-Min Huang ◽  
Chiao Lo ◽  
Chiao-Feng Cheng ◽  
Cheng-Hsun Lu ◽  
Song-Chou Hsieh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Serum Biomarkers ◽  
Healthy Controls ◽  
Granulomatous Mastitis ◽  
C Reactive Protein ◽  
Idiopathic Granulomatous Mastitis ◽  
Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

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