Results of Coupled Plasma Filtration Adsorption (CPFA) Treatment Applied to Critical COVID-19 Patients in Intensive Care Unit

Results of Coupled Plasma Filtration Adsorption (CPFA) Treatment Applied to Critical COVID-19 Patients in Intensive Care Unit

Objective: The novel coronavirus, called SARS-CoV-2, causes COVID-19 disease and began a pandemic on a global scale. Uncontrolled cytokine production is observed especially in COVID-19 cases with severe progression and this situation is thought to be one of the causes of more severe disease progression and increased mortality. In our study, we aimed to assess the efficacy of Coupled Plasma Filtration Adsorption (CPFA) treatment in situations with severe disease progression like sepsis, septic shock and multiple organ failure, considered to be secondary to cytokine storm, in COVID-19 disease. Methods: Our study retrospectively screened data from 20 patients admitted to our intensive care unit and administered CPFA. CPFA was administered as 10 hours each session and 2 sessions with 12 hours interval. Results: After our CPFA treatment, there were statistically significant ameliorations in clinical and laboratory findings like SOFA scores, mainly, Horowitz values, fever and IL-6 values. Conclusion: The CPFA treatment removes the uncontrolled production of harmful cytokines/chemokines and toxic substances from the blood and shows promise in the treatment of the cytokine storm that develops in COVID-19 disease.

___

  • 1. Kurt NG, Çamcı M. COVID-19 and Other Viral Pneumonias. Dicle Tıp Dergisi / Dicle Med J. 2021; 48: 40-6.
  • 2. https://coronavirus.jhu.edu/map.html (Last access: 30.12.2021)
  • 3. D’Elia RV, Harrison K, Oyston PC, Lukaszewski RA, Clark GC. Targeting the ‘cytokine storm’ for therapeutic benefit. Clin Vaccine Immunol. 2013; 20: 319–27.
  • 4. Ramos-Casals M, Brito-Zeron P, Lopez-Guillermo A, Khamashta MA, Bosch X. Adult haemophagocytic syndrome. Lancet. 2014; 383(9927): 1503-16.
  • 5. McGonagle D, Sharif K, O’Regan A, Bridgewood C. Interleukin-6 use in COVID-19 pneumonia related macrophage activation syndrome. Autoimmun Rev. 2020; 19: 102537.
  • 6. Şit D, Kayabaşı H. SARS-CoV-2 ile İlişkili Akut Böbrek Hasarı. Dicle Tıp Dergisi / Dicle Med J. (2020) 47: 498-507.
  • 7. Jin YH, Cai L, Cheng SZ, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020; 7: 4.
  • 8. Bajema KL, Oster AM, McGovern OL, et al. Persons Evaluated for 2019 Novel Coronavirus- United States, January 2020. MMWR Morb Mortal Wkly Rep. 2020; 69: 166-70.
  • 9. Panagiotou A, Gaiao S, Cruz DN. Extracorporeal therapies in sepsis. J Intensive Care Med. 2013; 28: 281-95.
  • 10. Harm S, Gabor F, Hartmann J. Characterization of Adsorbents for Cytokine Removal from Blood in an In Vitro Model. J Immunol. 2015: 1-11.
  • 11. Conti P, Ronconi G, Caraffa A, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS CoV-2): anti-inflammatory strategies. J Biol Regul Homeost Agents. 2020; 34: 327-31.
  • 12. Jafarzadeh A, Chauhan P, Saha B, Jafarzadeh S, Nemati M. Contribution of monocytes and macrophages to the local tissue inflammation and cytokine storm in COVID-19: lessons from SARS and MERS, and potential therapeutic interventions. Life Sci. 2020; 257: 118102.
  • 13. Huang Q, Wu X, Zheng X, et al. Targeting inflammation and cytokine storm in COVID-19. Pharmacol Res. 2020; 159: 105051.
  • 14. Hassan J, Cader RA, Kong NCT, et al. Coupled plasma filtration adsorption (CPFA) plus continuous veno-venous haemofiltration (CVVH) versus CVVH alone as an adjunctive therapy in the treatment of sepsis. EXCLI J. 2013; 12: 681–92.
  • 15. Dastan F, Saffaei A, Mortazavi SM, et al. Continues renal replacement therapy (CRRT) with disposable hemoperfusion cartridge: a promising option for severe COVID-19. J Glob Antimicrob Resist. 2020; 21: 340-1.
  • 16. Berlot G, Agbedjro A, Tomasini A, et al. Effects of the volume of processed plasma on the outcome, arterial pressure and blood procalcitonin levels in patients with severe sepsis and septic shock treated with coupled plasma filtration and adsorption. Blood Purif. 2014; 37: 146–51.
  • 17. Ronco C, Ricci Z, Husain-Syed F. From Multiple Organ Support Therapy to Extracorporeal Organ Support in Critically Ill Patients. Blood Purif. 2019; 48: 99-105.
  • 18. Jain U. Effect of COVID-19 on the Organs. Cureus.2020; 12: e9540.
  • 19. Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020; 97: 829-38.
  • 20. Li Z, Wu M, Yao J, et al. Caution on kidney dysfunctions of COVID-19 patients. Preprint from MedRxiv, 12 Feb 2020.
  • 21. Mancini E and Santoro A. La plasmaferesi in terapia intensiva. G Ital Nefrol. 2012; 29 (S54): S91- S102.
  • 22. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020; 46: 846-8.
  • 23. Kang S, Tanaka T, Narazaki M, Kishimoto T. Targeting Interleukin-6 signaling in clinic. Immunity. 2019; 50: 1007-23.
  • 24. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395 (10223): 497-506.
  • 25. Kucukcan NE, Kucukcan A. The relationship between hemogram parameters with clinical progress in COVID-19 patients. Dicle Tıp Dergisi / Dicle Med J (2020) 47: 763-9
  • 26. Ebik B, Ekin N, Bacaksız F, Kılıç J. The Frequency Of Development Of Liver Damage Related To Treatment In Patients With Covid-19, How Favipravir Is Effect On This Situation? Dicle Med J. 2021; 48: 338-43
  • 27. Paliogiannis P, Zinellu A. Bilirubin levels in patients with mild and severe Covid-19: A pooled analysis. Liver Int. 2020; 40: 1787-8.
  • 28. Matthay MA, Ware LB, Zimmerman GA. The acute respiratory distress syndrome. J Clin Invest. 2012; 122: 2731-40.
  • 29. Lambden S, Laterre PF, Levy MM, Francois B. The SOFA score-development, utility and challenges of accurate assessment in clinical trials. Critical Care, 2019; 23.1: 1-9.
  • 30. Tee YS, Fang HY, Kuo IM, et al. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018 Feb; 97: e9654.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: 4
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
Sayıdaki Diğer Makaleler

İkinci Trimester Muayenesinde Tanı Alan İzole Aberran Sağ Subklavian Arter (ARSA): Nasıl Yaklaşalım?

Elif Ganime AYGÜN, Umut SARI, Özlem PATA, Talat Umut KUTLU DİLEK

Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis

Tuncay GÜNDÜZ, Gonca ÖZCAN, Arman ÇAKAR, Halil İbrahim AKÇAY, Ayşe Nur ÖZDAĞ ACARLI, Mefküre ERAKSOY, Murat KÜRTÜNCÜ

MPV, RDW, LAKTAT, NA ve Albumin Düzeyleriyle Yoğun Bakım Hasta Mortalitesi Arasındaki İlişki

Ahmet AYDIN, Osman KAÇMAZ, Mesut ÖTERKUŞ, Ökkeş Hakan MİNİKSAR

Karpal Tünel Sendromunun Şiddeti İle Nötrofil/Lenfosit ve Platelet/Lenfosit Oranının Arasındakı İlişki

Zahide MAİL GÜRKAN, Aygül TANTİK PAK, Yıldızhan ŞENGÜL, İlker ÖZTÜRK

Rekürren İskemik İnme / Geçici İskemik Atak ile Atriyal Fibrilasyon İlişkisi

Sevda DİKER, Anıl TANBUROĞLU

Pankreas Kanseri Tanılı Hastalarımızda Prognostik Faktörlerin İncelenmesi

Ramazan YOLAÇAN, Ercan YİĞİT, Ümit KARABULUT, Ali ÜZEL, Feyzullah UÇMAK, Muhsin KAYA

Evaluation of Demographic and Clinical Data of Herpes Zoster Patients Admitted To Tertiary Referral Dermatology Clinic During COVID-19 Pandemic

Ayse Nilhan ATSÜ, Görkem ORUC ADALI, Nazlı CAF, Zafer TÜRKOGLU

Prognostic Significance of Monocyte to High-density Lipoprotein Ratio in Patients With Chronic Coronary Artery Occlusion

Muhammed DEMİR, Mehmet ÖZBEK, Adem AKTAN, Tuncay GÜZEL, Burhan ASLAN, Hakkı ŞİMŞEK

Dicle Üniversitesi Yanık Merkezinde 2011-2020 Yılları Arasında Tedavi Edilen Yanık Hastalarının Epidemiyolojik Olarak İncelenmesi

Mehmet Fatih AKKOÇ, Mehmet ÖZDEMİR

Which COVID-19 Patients Die in Intensive Care Unit (ICU) in Turkey

Recep DURSUN, Cigdem MERMUTLUOGLU, Fesih AKTAR, Recep TEKİN, Mahir KUYUMCU, İsmail YİLDİZ, Ali Kemal KADİROGLU, Mehmet TÜRK, Erkan ERBAS, Mustafa Kemal CELEN