Use of CytoSorb therapy to treat critically ill coronavirus disease 2019 patients: a case series

Abstract

Background Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019. Case presentation This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients’ average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy. Conclusions All three patients improved clinically and survived.

Role of Cytosorb in Severe Covid 19 Patients to Combat Cytokine Storm– A Case Series of 3 Patients

“…Another case series published by Mehtha et al, reported the use of Cytosorb after 72 hrs of ICU admission for 24 hrs reported a significant decrease in the levels of CRP and 100% survival rate 18 al, reported a case study of a 51 years old male COVID 19 patients who survived cytokine storm upon treating with Cytosorb and definite treatment 20 . Another case study conducted by Berlot et al, reported use of Cytosorb along with Tocilizumab reported a positive result in terms of extubation after 10 days of the therapy and radiological imaging suggestive of improvement in the lung fields 21 .…”

“…In a 3 months span of its first appearance in Wuhan, China, it was declared as Pandemic by WHO. In India about 3-10% patients are requiring intubation and 10-20% are requiring ICU admission 2,3 . The mortality rate was 49% 4 .…”

Acute Kidney Injury and Blood Purification Techniques in Severe COVID-19 Patients

“…Results from a single-center open-label single-arm study in Northern Macedonia [ 90 ] and from a multicenter trial lead in Mexico City comparing CRRT with AN69 vs. oXiris in COVID-19 patients [ 91 ] are eagerly expected. Interestingly, the use of Cytosorb and the oXiris cartridge in critically ill COVID-19 patients improves the oxygenation index, reduces CRP, and warrants hemodynamic stabilization in previous observational studies [ 92 , 93 , 94 , 95 , 96 ].…”

Sepsis Management in Southeast Asia: A Review and Clinical Experience

“…The patients showed significant improvement in clinical outcomes and biochemical parameters post-CytoSorb ® therapy. The mean arterial pressure (MAP) improved, C-reactive protein levels decreased post-therapy, and the patients were discharged [120]. Song et al reported the high survival rates of critically-ill COVID-19 patients on extracorporeal membrane oxygenation by using CytoSorb ® therapy in the retrospective multi-centric study [121].…”

“…Song et al reported the high survival rates of critically-ill COVID-19 patients on extracorporeal membrane oxygenation by using CytoSorb ® therapy in the retrospective multi-centric study [121]. Table 2 summarizes the peer-reviewed articles examining the benefits of CytoSorb ® treatment [115,116,120,[122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137]. Most of the evidence regarding the effectiveness of CytoSorb ® is based on case series, case studies and retrospective reports.…”