CytoSorb purification in critically ill SARS-CoV-2 patients

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Biomedical Engineering

Background:

• Severe COVID-19 can lead to refractory acute respiratory distress syndrome (ARDS).
• Cytokine storm and coagulation activation are key features of SARS-CoV-2 infection.
• Extracorporeal cytokine removal offers a potential therapeutic strategy.

Purpose of the Study:

• To evaluate the clinical experience and effectiveness of CytoSorb treatment.
• To assess CytoSorb's impact on inflammatory markers and clinical outcomes in ARDS patients with SARS-CoV-2.
• To identify potential benefits and challenges of CytoSorb therapy in this population.

Main Methods:

• Retrospective observational study involving 15 patients with refractory ARDS due to SARS-CoV-2.
• Patients received CytoSorb therapy, often alongside venovenous extracorporeal membrane oxygenation (VV ECMO) and mechanical ventilation.
• Laboratory parameters and clinical outcomes were analyzed pre- and post-treatment.

Main Results:

• Significant reductions observed in C-reactive protein, total bilirubin, direct bilirubin, and D-dimers.
• Trends towards reduction in lactate dehydrogenase, creatine phosphokinase, and fibrinogen.
• Mortality rate was 53%; 47% of patients were discharged, with some recovering native lung function or bridged to lung transplantation.
• Frequent premature circuit clotting occurred despite adequate anticoagulation.

Conclusions:

• CytoSorb effectively improved laboratory parameters and reduced inflammation in severe COVID-19 ARDS patients.
• No treatment-related adverse effects were recorded.
• CytoSorb shows promise in mitigating inflammation and coagulation activation in SARS-CoV-2 infection, warranting further investigation.