The Role of Hemoperfusion in COVID-19 Infection: A Case Series

Ali Amirsavadkouhi; Alireza Jahangirifard; Reza Shahrami; Saeid Safari; Faezeh Feizabadi; Zahra Mirshafiei Langari; Alireza Dastan; Seyed Bashir Mirtajani; Shayan Ghaznavi; Farzaneh Dastan

doi:10.18502/aacc.v7i3.6912

Ali Amirsavadkouhi Critical Care Medicine, Chairman of Iranian Critical Care Society, Mehrad Hospital, Tehran, Iran
Alireza Jahangirifard Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Reza Shahrami Health and Family Research Center, National Iranian Oil Company (NIOC) Hospital, Tehran, Iran.
Saeid Safari Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faezeh Feizabadi Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Zahra Mirshafiei Langari Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Dastan Ernest and Julio Gallo Management Program, School of Engineering, University of California, Merced, United States.
Seyed Bashir Mirtajani Lung transplant Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shayan Ghaznavi Noor Afshar Hospital, Tehran, Iran.
Farzaneh Dastan Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v7i3.6912

Keywords: Coronavirus disease 2019; Hemoperfusion; Acute respiratory distress syndrome

Abstract

The rapid expansion of a novel human infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into a pandemic, affecting thousands of people world wild. Some patients with coronavirus disease 2019 (COVID-19) develop severe infection, which may progress to acute respiratory distress syndrome, multiple organ failure, and death. Increasing studies indicate that abnormal elevation of cytokine levels in response to SARS-CoV-2 may contribute to the pathological process that leads mortality of COVID-19. Thus, application of extracorporeal hemoperfusion (HP) for removal of excessive cytokines from the blood can potentially mitigate or reverse cytokine storm related complications of COVID-19.

Here, we presented series of COVID-19 patients, who were treated with HP (HA 380 cartridge, Jafron Biomedocal Co, China). The medical records were evaluated retrospectively to determine the effect of HP on patients’ clinical outcome. Our results showed that HP improvee PO2 and O2 saturation in patients with severe COVID-19. After the last courses of HP, 5 out of 6 patients were extubated and transferred to the general ward with an acceptable medical condition. The following case series demonstrate the promising role of HP in controlling the consequential effect of cytokine storm following a COVID-19 infection, which could facilitate patient survival.