Author/Authors :
Hashemian, Mohammadreza Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Shafigh, Navid Department of Anesthesiology and Critical Care Medicine - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Afzal, Golnaz Department of Clinical Pharmacy - School of Pharmacy - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Jamaati, Hamidreza Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Mortaz, Esmaeil Clinical Tuberculosis and Epidemiology Research Center - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Tabarsi, Payam Clinical Tuberculosis and Epidemiology Research Center - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Marjani, Majid Clinical Tuberculosis and Epidemiology Research Center - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Malekmohammad, Majid Tracheal Diseases Research Center (TDRC) - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Dastan, Farzaneh Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Mortazavi, Mehdi Department of Nursing - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Sadr, Makan Virology Research Center (VRC) - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Idani, Esmaeil Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Khoundabi, Batoul Research Center for Health Management in Mass Gathering - Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran , Mohamadnia, Abdolreza Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Abedini, Atefeh Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Kiani, Arda Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Moniri, Afshin Virology Research Center (VRC) - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Nadji, Alireza Virology Research Center (VRC) - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Yassari, Fatemeh Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Mokhber Dezfuli, Mojtaba Lung Transplantation Research Center - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Varahram, Mohammad Mycobacteriology Research Center - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Eshaghi, Faezeh Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Malekpour, Mahdi Geisinger Medical Center, Danville, PA , USA , Velayati, Aliakbar Chronic Respiratory Diseases Research Center - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract :
Background: Inflammatory mediators are an important component in the pathophysiology of the coronavirus disease 2019 (COVID-19). This study aimed to assess the effects of reducing inflammatory mediators using hemoperfusion (HP) and continuous renal replacement therapy (CRRT) on the mortality of patients with COVID-19.
Materials and Methods: Twelve patients with confirmed diagnosis of COVID-19 were included. All patients had acute respiratory distress syndrome (ARDS). Patients were divided into three groups, namely, HP, CRRT and HP+CRRT. The primary outcome was mortality and the secondary outcomes were oxygenation and reduction in inflammatory mediators at the end of the study.
Results: Patients were not different at baseline in demographics, inflammatory cytokine levels, and the level of acute phase reactants. Half of the patients (3 out of 6) in the HP+CRRT group survived along with the survival of one patient (1 out of 2) in the HP group. All four patients in the CRRT group died. Serum creatinine (SCr), Interleukin-1 (IL1), Interleukin-6 (IL6), Interleukin-8 (IL8), partial pressure of oxygen (PaO2), O2 saturation (O2 sat), and hemodynamic parameters improved over time in HP+CRRT and CRRT groups, but no significant difference was observed in the HP group (All Ps > 0.05).
Conclusion: Combined HP and CRRT demonstrated the best result in terms of mortality, reduction of inflammatory mediators and oxygenation. Further investigations are needed to explore the role of HP+CRRT in COVID-19 patients.
