The Role of Immunomodulatory Therapy with Oxiris in COVID-19 with Renal Failure and Immune Dysfunction.

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-07-22 DOI:10.1159/000539833

Nerea Quílez Trasobares, María González-Fernández, Jesús Abelardo Barea-Mendoza, María Dolores Arias-Verdú, Jesús Emilio Barrueco-Francioni, Gemma Seller-Pérez, Zaira Molina-Collado, Amanda Lesmes González-de Aledo, Manuel Herrera-Gutiérrez, Jose Ángel Sánchez-Izquierdo Riera

{"title":"The Role of Immunomodulatory Therapy with Oxiris in COVID-19 with Renal Failure and Immune Dysfunction.","authors":"Nerea Quílez Trasobares, María González-Fernández, Jesús Abelardo Barea-Mendoza, María Dolores Arias-Verdú, Jesús Emilio Barrueco-Francioni, Gemma Seller-Pérez, Zaira Molina-Collado, Amanda Lesmes González-de Aledo, Manuel Herrera-Gutiérrez, Jose Ángel Sánchez-Izquierdo Riera","doi":"10.1159/000539833","DOIUrl":null,"url":null,"abstract":"Introduction: The main objective of this study was to evaluate the impact of hemoadsorption on the elimination of inflammatory mediators.Methods: A prospective, bicenter, observational cohort study was conducted between March 2020 and February 2022 to explore the immunomodulatory response, demographic and clinical characteristics of individuals with COVID-19 admitted to the ICU with severe acute respiratory failure and in need of CRRT with Oxiris® with or without AKI.Results: Sixty-four patients were analyzed. Statistically significant differences were observed between exposed and unexposed groups, in relation to the reduction in D-dimer levels -15,614 (24,848.9) versus -4,136.5 (9,913.47) (p 0.031, d: 1.59, 95% CI: -21,830, -1,126). An increase in PCT was observed 0.47 (2.08) versus -0.75 (2.3) (p 0.044 95% CI: 0.03, 2.44). No differences were found in a decrease in CRP -4.21 (7.29) versus -1.6 (9.02) (p 0.22) nor in the rest of inflammatory parameters fibrinogen, IL-6, ferritin, lymphocytes, and neutrophils. Subgroup analysis in patients exposed to therapy also showed a significant decrease in D-dimer of 55% from baseline: 6,000 (1,984.5-27,750) pre-therapy versus 2,700 (2,119.5-6,145) (95% CI: -23,000, -2,489) post-therapy with a strong effect size (p 0.001, d: 0.65).Conclusion: The hemoadsorptive therapy in COVID-19 was associated with a significant decrease in D-dimer parameters without showing decreases in the rest of the clinical, inflammatory parameters and severity scales analyzed.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Purification","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000539833","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/22 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: The main objective of this study was to evaluate the impact of hemoadsorption on the elimination of inflammatory mediators.

Methods: A prospective, bicenter, observational cohort study was conducted between March 2020 and February 2022 to explore the immunomodulatory response, demographic and clinical characteristics of individuals with COVID-19 admitted to the ICU with severe acute respiratory failure and in need of CRRT with Oxiris® with or without AKI.

Results: Sixty-four patients were analyzed. Statistically significant differences were observed between exposed and unexposed groups, in relation to the reduction in D-dimer levels -15,614 (24,848.9) versus -4,136.5 (9,913.47) (p 0.031, d: 1.59, 95% CI: -21,830, -1,126). An increase in PCT was observed 0.47 (2.08) versus -0.75 (2.3) (p 0.044 95% CI: 0.03, 2.44). No differences were found in a decrease in CRP -4.21 (7.29) versus -1.6 (9.02) (p 0.22) nor in the rest of inflammatory parameters fibrinogen, IL-6, ferritin, lymphocytes, and neutrophils. Subgroup analysis in patients exposed to therapy also showed a significant decrease in D-dimer of 55% from baseline: 6,000 (1,984.5-27,750) pre-therapy versus 2,700 (2,119.5-6,145) (95% CI: -23,000, -2,489) post-therapy with a strong effect size (p 0.001, d: 0.65).

Conclusion: The hemoadsorptive therapy in COVID-19 was associated with a significant decrease in D-dimer parameters without showing decreases in the rest of the clinical, inflammatory parameters and severity scales analyzed.

查看原文本刊更多论文

在患有肾衰竭和免疫功能障碍的科维德 19 中使用奥西里斯进行免疫调节治疗的作用。

简介：本研究的主要目的是评估血液吸收对消除炎症介质的影响：本研究的主要目的是评估血液吸附对消除炎症介质的影响：2020年3月至2022年2月期间进行了一项前瞻性、双中心、观察性队列研究，以探讨因严重急性呼吸衰竭入住重症监护室、需要使用Oxiris®进行CRRT且伴有或不伴有AKI的COVID-19患者的免疫调节反应、人口统计学和临床特征：对 64 名患者进行了分析。在 D-二聚体水平方面，暴露组和未暴露组之间存在明显的统计学差异，前者为 -15614 (24848.9) vs -4136.5(9913.47) (p .031, d:1.59, 95% CI -21830, -1126)。观察到 PCT 上升 0.47(2.08) vs -0.75(2.3) (p .044 95% CI 0.03,2.44)。CRP -4.21(7.29) vs -1.6(9.02) (p .22)的下降与其他炎症指标纤维蛋白原、IL-6、铁蛋白、淋巴细胞和中性粒细胞的下降均无差异。对接受治疗的患者进行的亚组分析还显示，D-二聚体比基线值显著下降了55%；治疗前为6000（1984.5-277750），治疗后为2700（2119.5-6145）（95% CI -23000，-2489），效果非常明显（p .001，d:0.65）：结论：COVID 19 中的溶血疗法与 D-二聚体参数的显著下降有关，而其他临床、炎症参数和严重程度量表的分析结果均未显示下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.