The early start of hemoperfusion decreases the mortality rate among severe COVID‐19 patients: A preliminary study

Abstract

Background: Coronavirus disease-2019 (COVID-19)-related organ failure is partly related to a sepsis-like syndrome and extreme pro-inflammatory cytokine release, named cytokine storm. Therapeutic strategies that prevent the production of or remove the pro-inflammatory cytokines could potentially be an effective therapy in critically afflicted COVID-19 patients. Methods:In this clinical trial study, from April until June 2020, 68 COVID-19 patients (35 vs. 33 controls) with severe critical symptoms, and PaO 2 /FiO 2 (P/F) ratio less than 200 mmHg either received a single standard therapy or a combination of standard treatment for COVID-19 combined with hemoperfusion (hemofilter, HA330 D Javfron) for 4 h, in 3 consecutive days. The length of hospital stay and mechanical ventilation, the resolution of radiologic abnormalities, and the mortality rate were defined as the primary outcomes.Results: Demographic characteristics, the acute physiology, and chronic health evaluation score of both groups were similar (p > 0.05). Importantly, we noticed a significant mortality rate reduction in the perfused group compared with controls (37.1% vs. 63.6%, p = 0.02), this positive effect was stronger among those with a P/F ratio higher than 75 (mortality rate of 84.7% for P/F ratio < 75 vs. 15.4% for P/F ratio ≥ 75, p = 0.02). Conclusions:The results imply that early start of hemoperfusion could be more effective and significantly reduce the mortality rate among COVID-19 patients with critical diseases.

The Occurrence of Activated Leukocyte Cell Adhesion Molecule (ALCAM) and Its Predictive Factors in Patients with Oral Squamous Cell Carcinoma

“…This finding was consistent with different studies conducted in this field :10.31557/APJCP.2022.23.11.3735 Occurrence of ALCAM) and OSCC (Burandt et al, 2014;Lu et al, 2018;Sawhney et al, 2009;Tan et al, 2014;. However, in some other studies, no significant relationship was observed between ALCAM incidence and tumor size (Davies et al, 2008;Mikaeili et al, 2022;Tachezy et al, 2012). The significant relationship between ALCAM expression and tumor size can be related to the role of ALCAM in its proliferative stages and anti-apoptotic properties as well as the increase of ALCAM-ALCAM junctions in larger cell islets.…”

Can charcoal hemoperfusion treatment be an option for pediatric MIS‐C patients? A single‐center experience in a tertiary pediatric intensive care unit

“…In the review of Sanfİlippo F et al on hemoperfusion therapy in COVID‐19 patients, it was emphasized that hemoperfusion therapy was effective in reducing IL‐6 levels; however, more randomized controlled studies are needed on this subject 31 . A recent study, in which HA330 Disposable Hemoperfusion Cartridge (Jafron Biomedical Co., Ltd. China) was used, suggested that the early initiation of hemoperfusion significantly reduced mortality in critically ill COVID‐19 adult patients 32 . Another study with HA resin hemoperfusion cartridge (Model HA 280, Jafron Biomedical Co., Ltd.) reported that hemoperfusion at the inflammatory phase of the disease, especially before the intubation, reduced the need for mechanical ventilation, but hemoperfusion did not have any impacts on the duration of hospital and intensive care unit stay 33 .…”

“…31 A recent study, in which HA330 Disposable Hemoperfusion Cartridge (Jafron Biomedical Co., Ltd. China) was used, suggested that the early initiation of hemoperfusion significantly reduced mortality in critically ill COVID-19 adult patients. 32 Another study with HA resin hemoperfusion cartridge (Model HA 280, Jafron Biomedical Co., Ltd.) reported that hemoperfusion at the inflammatory phase of the disease, especially before the intubation, reduced the need for mechanical ventilation, but hemoperfusion did not have any impacts on the duration of hospital and intensive care unit stay. 33 Similarly, in a report of a 54-yearold male COVID-19 case, the application of CRRT/HP in the early stages of ARDS prevented the progression of the disease from moderate to severe ARDS, stabilizing and gradually enhancing the oxygen saturation, thus, removing the need for invasive mechanical ventilation.…”

Predictors of Clinical Efficacy of Cytokine Hemoadsorption in COVID-19 (Clinical Trial)

“…(2021) оценивают эффективность процедуры в ранние сроки нахождения в ОРИТ [7] (указывая не конкретные рамки, а динамику состояния, т. е., до ухудшения состояния, до потребности в механической респираторной поддержке), а в исследовании Haleh Mikaeili с соавт. (2021), оценивающем эффективность применения сорбции цитокинов в сравнении с контрольной группой пациентов без эфферентной терапии, средний срок начала лечения -7 дней с момента появления симптомов [8], что подтверждает данные, полученные в нашей работе.…”