Impact of extracorporeal hemadsorption on mortality in critically ill COVID-19 patients in the intensive care unit

Özlem Çakin, Melike Yüce Aktepe, Orbay Harmandar, Kamil Deveci, Özlem Esra Yildirim, Erdal Kurtoğlu
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Abstract

Background:The consequences of COVID-19, such as respiratory failure and mortality, require the search for fast and effective solutions. The aim of this retrospective study is to determine the effect of extracorporeal hemadsorption on mortality in severe COVID-19 cases hospitalized in the intensive care unit (ICU).Methods:Our study is retrospective, single-center, and observational. The study included ICU patients diagnosed with COVID-19 who received extracorporeal hemadsorption treatment between March 2020 and December 2020. Effects on mortality were examined by comparing pre- and post-hemadsorption values.Results:Seventeen patients were included in the study. The mortality rate in the study was 64.7%. After hemadsorption, an increase was observed in the lymphocyte numbers, APACHE-II, and SOFA values of the patients ( p = 0.026, 0.043, and 0.033; respectively). A significant decrease was observed in CRP and fibrinogen levels ( p = 0.003 and 0.005; respectively). In the non-surviving patient group, APACHE-II, SOFA, and procalcitonin values were found to be high before and after the procedure ( p = 0.002, 0.048, and 0.06; respectively).Conclusion:In COVID-19 patients, APACHE-II and SOFA scores may be useful in predicting the effectiveness of extracorporeal hemadsorption. Our study found that patients with higher APACHE-II and SOFA scores at baseline had a higher mortality rate after hemadsorption. These findings show that the use of intensive care scoring systems may be useful in determining which patients should receive extracorporeal hemadsorption and that hemadsorption should be performed in the early stages of the disease.
体外血液吸附对重症监护室 COVID-19 重症患者死亡率的影响
背景:COVID-19造成的后果,如呼吸衰竭和死亡,需要寻求快速有效的解决方案。本回顾性研究旨在确定体外血液吸附对重症监护病房(ICU)重症 COVID-19 患者死亡率的影响。研究对象包括在2020年3月至2020年12月期间接受体外血液净化治疗的确诊为COVID-19的重症监护病房患者。通过比较吸血前和吸血后的数值,研究了对死亡率的影响。研究中的死亡率为 64.7%。吸血后,观察到患者的淋巴细胞数量、APACHE-II 和 SOFA 值增加(p = 0.026、0.043 和 0.033;分别为 0.026、0.043 和 0.033)。CRP和纤维蛋白原水平也有明显下降(p = 0.003 和 0.005)。结论:在 COVID-19 患者中,APACHE-II 和 SOFA 评分可能有助于预测体外吸血的效果。我们的研究发现,基线 APACHE-II 和 SOFA 评分较高的患者在血液吸附后的死亡率较高。这些研究结果表明,使用重症监护评分系统可能有助于确定哪些患者应该接受体外血液吸附,而且血液吸附应该在疾病的早期阶段进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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