Effect of Hemoperfusion on short term survival of critically ill COVID-19 patients admitted to ICU

Abstract

Despite the potential and theoretical benefits of hemoperfusion in critically ill COVID-19 patients it remains an expensive experimental intervention in these patients that seems unlikely to be more positive effect in patients who take concurrent corticosteroids. Therefore in this study we aimed to evaluate the effect of hemoperfusion in inflammatory levels and outcome of critically ill COVID-19 patients. Methods and Materials: 197 patients admitted to general and neurology ICUs of Imam Reza Hospital with a diagnosis of COVID-19 who met the inclusion criteria were included in this double-blind randomized clinical trial. Within 24 hours after meeting the inclusion criteria, patients were randomly assigned to receive standard care or standard care and additional CytoSorb treatment (hemoperfusion) for 3-5 days. The primary Outcome of the study was the duration of mechanical ventilation and improvement of patients' hemodynamics. Secondary outcomes were mortality, length of ICU stay, change in plasma interleukin-6 (IL-6) levels, vasopressor use, and change in organ function as assessed by SOFA score. Data were analyzed using Spss Ver 22 software. Results: Mortality was reported in 48 (48.5%) patients in the control group and in 32 (32.7%) patients in the hemoperfusion treatment group. Comparing the changes in the factors related to disease severity markers in the pre- and post-intervention measurements between the control and hemoperfusion groups, the changes in all variables except for Pco2, BUN and Cr were statistically significant between the two groups. (P<0.05). There was a statistically significant difference between the two groups of patients in comparing the number of hemoperfusion sessions (P = 0.02).