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Hemoperfusion in COVID-19.

Tanat Lertussavavivat1,2,3, Nattachai Srisawat1,2,3,4,5,6

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Hemoperfusion using various cartridges may help manage severe SARS-CoV-2 infections by mitigating cytokine storms. However, current evidence is inconsistent, necessitating further research to confirm benefits and patient selection for this critical care intervention.

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Area of Science:

  • Critical Care Medicine
  • Immunology
  • Infectious Diseases

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection triggers a hyperinflammatory response, or cytokine storm.
  • This cytokine storm can lead to sepsis-like conditions, capillary leakage, thrombosis, and multi-organ damage.
  • Existing research on hemoperfusion for SARS-CoV-2 is limited and shows inconsistencies.

Purpose of the Study:

  • To review the effectiveness and risks of hemoperfusion techniques in severe SARS-CoV-2 infection.
  • To identify the potential role of hemoperfusion in managing hyperinflammation and its complications.
  • To highlight the need for further research to establish consensus on hemoperfusion use.

Main Methods:

  • Review of case series and randomized controlled trials on hemoperfusion cartridges (HA330, CytoSorb, Polymyxin, oXiris, Seraph 100).
  • Analysis of reported outcomes related to clinical benefits and adverse events.
  • Synthesis of existing evidence to identify gaps and inconsistencies.

Main Results:

  • Various hemoperfusion cartridges have been explored for severe SARS-CoV-2.
  • Inconsistent findings exist across studies regarding efficacy and safety.
  • No established consensus on the use of hemoperfusion in SARS-CoV-2 patients.

Conclusions:

  • Hemoperfusion shows potential in managing SARS-CoV-2-induced hyperinflammation.
  • Further high-quality research is essential to validate clinical benefits.
  • Identifying optimal patient populations and timing for hemoperfusion is crucial.