The absorbing filter Oxiris in severe coronavirus disease 2019 patients: A case series

Artif Organs. 2020 Dec;44(12):1296-1302. doi: 10.1111/aor.13786. Epub 2020 Sep 1.

Abstract

Hypercytokines cause acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19) patients, which is the main reason for intensive care unit treatment and the leading cause of death in COVID-19 patients. Cytokine storm is a critical factor in the development of ARDS. This study evaluated the efficacy and safety of Oxiris filter in the treatment of COVID-19 patients. Five patients with COVID-19 who received continuous renal replacement therapy (CRRT) in Henan provincial people's hospital between January 23, 2019 and March 28, 2020, were enrolled in this study. Heart rate (HR), mean arterial pressure (MAP), oxygenation index (PaO2 /FiO2 ), renal function, C-reactive protein (CRP), cytokines, procalcitonin (PCT), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure score (SOFA), and prognosis were compared after CRRT. Five COVID-19 patients, three males and two females, aged 70.2 ± 19.6 years, were enrolled. After treatment, HR (101.4 ± 14.08 vs. 83.8 ± 6.22 bpm/min), CRP (183 ± 25.21 vs. 93.78 ± 70.81 mg/L), IL-6 (3234.49 (713.51, 16038.36) vs. 181.29 (82.24, 521.39) pg/mL), IL-8 (154.86 (63.97, 1476.1) vs. 67.19 (27.84, 85.57) pg/mL), and IL-10 (17.43 (9.14, 41.22) vs. 4.97 (2.39, 8.70) pg/mL), APACHE II (29 ± 4.92 vs. 18.4 ± 2.07), and SOFA (17.2 ± 1.92 vs. 11.2 ± 3.4) significantly decreased (P < .05), while MAP (75.8 ± 4.92 vs. 85.8 ± 6.18 mm Hg), and PaO2 /FiO2 (101.2 ± 7.49 vs. 132.6 ± 26.15 mm Hg) significantly increased (P < .05). Among the five patients, negative conversion of nucleic acid test was found in three cases, while two cases died. No adverse events occurred during the treatment. Our study observed a reduced level of overexpressed cytokines, stabilization of hemodynamic status, and staged improvement of organ function during the treatment with Oxiris filter.

Keywords: Oxiris; coronavirus disease 2019; cytokine storm; hemodynamics.

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • C-Reactive Protein / analysis
  • COVID-19 / complications
  • COVID-19 / therapy*
  • Continuous Renal Replacement Therapy / instrumentation*
  • Cytokine Release Syndrome / complications
  • Cytokine Release Syndrome / prevention & control*
  • Female
  • Heart Rate
  • Humans
  • Interleukins / blood
  • Male
  • Membranes, Artificial*
  • Middle Aged
  • Organ Dysfunction Scores
  • Oxygen / blood
  • Respiratory Distress Syndrome / prevention & control*
  • Respiratory Distress Syndrome / virology
  • Retrospective Studies

Substances

  • Interleukins
  • Membranes, Artificial
  • C-Reactive Protein
  • Oxygen