Effectiveness of hemoperfusion (HP) in hemodialysis (HD) patients with Covid-19 infection

Griveas, Ioannis

doi:10.1016/j.transci.2022.103589

Cited by 2 publications

(7 citation statements)

References 17 publications

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“…Although the total pooled effect estimates remained similar in the leave-one-out sensitivity analyses, the results changed significantly after removing some of the studies (30)(31)(32)36), suggesting instability in outcome reporting, and therefore should be interpreted carefully (Fig. 6A).…”

Section: Sensitivity Analysismentioning

confidence: 96%

“…All studies were performed in patients with severe COVID-19 in the medical ICU under various hyperinflammatory conditions. Most of the included patients with severe COVID-19 that remained in a compensatory state of oxygen saturation (12,(30)(31)(32)(33)(34)(35)(36)(37)(38). All the included studies were completed at 2020-2021 period, with seven studies recruiting COVID-19 patients in 2020, and seven studies recruiting patients from 2020 to 2021.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…For non-RCTs, no study fulfilled all NOS indicators. The most common methodological limitation in these included studies was the lack of a description of the outcome assessment (13,34,(36)(37)(38)(39), the demonstration that the outcome of interest was not present at the start of the study (12,(30)(31)(32)(33)35,36,(39)(40)(41) and the controls being the important factor (13,34,(36)(37)(38)(39). The quality assessment scores ranged from 5 to 9 (out of a possible score of 9; Additional File 4, http://links.lww.com/SHK/B742).…”

Section: Quality Evaluationmentioning

confidence: 99%

“…The quality assessment scores ranged from 5 to 9 (out of a possible score of 9; Additional File 4, http://links.lww.com/SHK/B742). Two non-RCTs were rated as having a moderate quality of research (12,33), and nine were rated as high-quality research (30)(31)(32)(34)(35)(36)(39)(40)(41).…”

Section: Quality Evaluationmentioning

confidence: 99%

“…Furthermore, 446 studies were excluded after screening the title and abstract, according to the inclusion and exclusion criteria, resulting in 23 studies that underwent full-text assessment. Finally, 14 published studies and 2 ongoing trials were enrolled in this systematic living review and meta-analysis (12,13,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43).…”

Section: Study Selectionmentioning

confidence: 99%

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Efficacy of supplemental hemoadsorption therapy on severe and critical patients with COVID-19: an evidence-based analysis

He,

Lin,

Cai

et al. 2023

Shock

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Background The COVID-19 pandemic has posed a disproportionately high threat to the global health system and social stability. COVID-19 damage can lead to hyperinflammation and tissue damage due to a "cytokine storm", which in turn contributes to an increase in the mortality rate. Extracorporeal hemoadsorption therapy (HAT) in patients with severe COVID-19 may improve organ function and stabilize hemodynamic status; however, the effects of supplemental HAT remain controversial. Methods The Cochrane Library, Embase and PubMed databases were comprehensively searched from inception to August 20, 2022 for potential studies. Results A total of 648 patients with severe COVID-19 in 3 randomized controlled trials and 11 observational studies met the inclusion criteria. A meta-analysis indicated that supplemental HAT significantly improved the mortality rate of patients with severe COVID-19 compared with conventional therapy (CT) (RR = 0.74, 95% CI: [0.56, 0.96], P = 0.026). In subgroup analyses, supplemental HAT significantly decreased mortality rates in patients without extracorporeal membrane oxygenation (ECMO) support (RR = 0.59, 95% CI: [0.44, 0.79], P < 0.0001), while a significant difference was not observed in patients requiring ECMO support (RR = 1.61, 95% CI: [0.63, 4.09], P = 0.316). Standardized mean difference (SMD) meta-analysis showed that IL-6 removal was more significant in HAT group than CT group (SMD = 0.46, 95% CI: [0.01, 0.91], P = 0.043), followed by CRP (SMD = 0.70, 95% CI: [-0.04, 1.44], P = 0.065) and IL-8 (SMD = 0.36, 95% CI: [-0.34, 1.07], P = 0.311). No evidence of substantial publication bias concerning mortality was observed. Conclusion Given the better mortality outcomes, HAT confers clinical benefits to patients with severe COVID-19, which correlated with cytokine removal by HAT. Cytokine adsorption may not provide clinical benefits for patients with severe COVID-19 requiring ECMO and should be used with caution. However, due to the very low quality of evidence, multicenter randomized trials with large sample sizes are required to verify these findings.

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Section: Sensitivity Analysismentioning

confidence: 96%