Effect of hemoperfusion in critically ill COVID-19 patients: a case series from a single-center hospital in Indonesia.

Abstract

Introduction: Hemoperfusion (HP), a blood filtration method targeting the removal of toxins and inflammatory elements, was investigated in this study. The objective was to present the observations in four individuals with confirmed COVID-19 who underwent several rounds of HP utilizing the HA330 cartridge at a hospital in Indonesia.

Case studies: We report four cases of COVID-19 patients who underwent HP. The decision to start HP in COVID-19 patients hinges on severe illness and specific indications such as refractory hypercytokinemia or cytokine storm syndrome, despite conventional treatments. Inclusion criteria were evidence of organ dysfunction; particularly the lungs, kidneys, or liver; and significant inflammatory markers or laboratory abnormalities. The four cases described here received HP as a supplementary treatment for COVID-19. However, only two of these patients successfully finished three cycles of HP, and just one exhibited improvement and was eventually declared to have recovered.

Conclusions: The rationale behind HP in COVID-19 patients lies in its potential to mitigate the cytokine storm, a hallmark of severe disease. COVID-19 is known to trigger an excessive inflammatory response, leading to organ damage and respiratory distress. HP, through the use of devices such as the HA330 cartridge, aims to remove inflammatory cytokines and toxins from blood circulation. Utilizing at least three sessions of HA-330 HP in addition to standard treatment in severe COVID-19 demonstrated a beneficial effect on decreasing inflammatory biomarkers, although it did not affect mortality rates.