CytoSorb® in the Treatment of Severely-Ill Patient with Post-COVID-19 Complications: A Case Report

Abstract

Background: COVID-19 affects the respiratory tract leading to acute respiratory distress syndrome (ARDS) and serious pneumonia. Severe cases of COVID-19 are associated with hyperactive immune response characterized by the release of interleukins, interferons, chemokines, tumor-necrosis factors, and various other mediators. Use of CytoSorb ® , an extracorporeal hemadsorption has been observed to alleviate the cytokine storm, hence ameliorate the pulmonary function and hemodynamic stability. Case Summary: A 42-year-old man, a case of post-COVID-19 pneumonia was admitted in hospital with the complaints of headache, vomiting, and abdominal discomfort associated with generalized weakness. He had pre-existing comorbidities of diabetes, hypertension, and acute kidney injury. The blood parameters showed increased levels of inflammatory biomarkers which indicated the presence of cytokine storm and sepsis. The patient was given CytoSorb ® therapy after 7 days of admission in ICU in two sessions of 18 and 20 hours using two separate devices at the interval of 6 hours. After the treatment, remarkable decreased in CRP values (39%), S. Creatinine (6.52%), S. Lactate (54%), leucocytes (44%) and PCT (33%) was observed. A reduction in IL-6 levels (from 5975 to 3171 pg/ml, 46.9%) and norepinephrine dose (from 8 to 0.2 mcg/kg/hr, 25%) was reported. The patient was discharged from hospital in 54 days in stable condition. Conclusion: CytoSorb ® therapy was effective in providing hemodynamic stability, improving organ dysfunction, and modulating the cytokine storm.

Advances in attractive therapeutic approach for macrophage activation syndrome in COVID-19

“…In a randomized controlled trial, it was clearly proved that Hemadsorption can early relieve organ dysfunction in critically ill patients with COVID-19 and stabilize the clinical symptoms, although it has no significant impact on inflammatory indicators and 28 day mortality ( 105 ). Besides, in a case report by Rajib Paul et al, they proposed that Hemadsorption was effective in providing hemodynamic stability, improving organ dysfunction, and modulating the cytokine storm ( 106 ).…”