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. 2024 Jul 31;14(1):17651.
doi: 10.1038/s41598-024-68592-4.

Efficacy of additional hemoperfusion in hospitalized patients with severe to critical COVID-19 disease

Supattra Chiewroongroj  1 , Ranistha Ratanarat  2 , Thummaporn Naorungroj  1 , Napassorn Teeratakulpisarn  1 , Suapa Theeragul  3
Affiliations

Efficacy of additional hemoperfusion in hospitalized patients with severe to critical COVID-19 disease

Supattra Chiewroongroj et al. Sci Rep. .

Abstract

The evidence supporting additional hemoperfusion (HP) with cytokine adsorbents for improving clinical outcomes in severe to critical coronavirus disease 2019 (COVID-19) patients remains limited. We compared severe to critical COVID-19 patients who received additional HP with a cytokine adsorbent to matched cases receiving standard medical treatment (SMT). The primary outcome was hospital mortality. In our study, we matched 45 patients who received additional HP 1:1 with the SMT group based on key clinical parameters. The hospital mortality rates did not differ between the groups (33% vs 38%, p = 0.83). The HP group had a significantly shorter ICU stay (22 vs 32 days; p = 0.017) and reduced mechanical ventilation duration (15 vs 35 days; p < 0.001). Additionally, the incidence of pulmonary complications (20% vs 42%; p = 0.04), sepsis (38% vs 64%; p = 0.02), and disseminated intravascular coagulopathy (DIC) (13% vs 33%; p = 0.046) were significantly lower in the HP group. In conclusion, among severe to critical COVID-19 patients, additional HP with a cytokine adsorbent did not improve hospital mortality. However, it reduced ICU length of stay, mechanical ventilator days, and incidences of lung complications, sepsis, and DIC. Trial registration: TCTR20231002006. Registered 02 October 2023 (retrospectively registered).

Keywords: Blood purification; Coronavirus disease 2019; Cytokine; HA-330; Hemoperfusion; Mortality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The Treatment guideline for critically ill patients with COVID-19 in Siriraj Hospital. CRP C-Reactive Protein, DOS Day of Symptom, RA Room Air, SpO2 Saturation of peripheral oxygen.
Figure 2
Figure 2
Flow Diagram of the Study. ARDS Acute Respiratory Distress Syndrome, IMV Invasive Mechanical Ventilation, SOFA Sequential Organ Failure Assessment Score.
Figure 3
Figure 3
Standard Mean Difference before and after matching. The figure showed the matching strategy which hollow circles represented all patients while black circles represented the matched patients using covariates including sequential organ failure assessment score (SOFA), acute respiratory distress syndrome (ARDS) and use invasive mechanical ventilation (IMV). After balancing with those variables, the mean standard difference value was less than 0.1.
See this image and copyright information in PMC

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