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ORIGINAL ARTICLE
Year : 2021  |  Volume : 26  |  Issue : 1  |  Page : 34

Hemoperfusion in patients with severe COVID-19 respiratory failure, lifesaving or not?


1 Anesthesiology and Critical Care Research Center, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
3 Bamdad Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
5 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
6 Department of Pulmonology, Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
7 Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
8 Department of Internal Medicine, Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
9 Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
10 Khatamolanbia Natanz Regional Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
11 Department of Anesthesiology and Critical Care Medicine, Critical care Research Center, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
12 Department of Epidemiology and Biostatics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
13 Department of Neurosurgery, Neuroscience Research Center, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
14 Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
15 Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Dr. Firouzeh Moeinzadeh
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Sofe Ave., Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrms.JRMS_1122_20

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Background: The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The “cytokine storm” is considered as the main cause of pathogenesis for coronavirus disease-19 (COVID-19)-related respiratory failure, hemoperfusion may be a modality for treatment of disease. Materials and Methods: Thirty-seven an patients with positive real-time polymerase chain reaction for SARStions2 in an upper respiratory tract sample or typical chest computed tomography lesion were eligible for this case–control study. Patients meeting the criteria for hemoperfusion including clinical and laboratory indices, were evaluated for outcomes such as hospitalization length and mortality. Patients were divided into three groups, i.e., patients who received hemoperfusion without a need for mechanical ventilation (MV), patients who received hemoperfusion before MV, and patients who received hemoperfusion after MV. Results: Among 37 patients with COVID-19 respiratory failure, 32% were female with a mean age of 55.54 (standard deviation 14.1) years. There was no statistically significant difference between the three groups in terms of length of hospital stay and intensive care unit (ICU) stay (P-tayns: 0.593 and 0.243, respectively, confidence interval [CI]: 95%). Heart rate, respiratory rate, PaO2/FIO2, high-sensitivity C-reactive protein, and ferritin significantly improved after the application of hemoperfusion in all groups (P < 0.05, CI: 95%). Conclusion: It seems that applying hemoperfusion in the inflammatory phase of the disease, especially before the intubation, reduce the need for MV. However, hemoperfusion does not have any impacts on the duration of hospital and ICU stay.


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