Background Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines. Methods This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH). Results Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them ( p < 0.001). Serum IL-6 showed a reduction from 139.70 ± 105.62 to 72.06 ± 65.87 pg/mL ( p = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L ( P = 0.016). Conclusions Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients. Trial registration The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2 .
【저자키워드】 Coronavirus infection, Extracorporeal dialysis, Critical illness, 【초록키워드】 Treatment, coronavirus disease, Coronavirus infection, Efficacy, coronavirus, Cytokines, randomization, Antiviral, IL-6, drugs, clinical trials, C-reactive protein, oxygen, Intervention, Elimination, Hemoperfusion, Protein, oxygen saturation, Iran, Critically ill, clinical, Patient, Controlled trial, age, Inflammatory cytokines, women, respiratory, registry, university, COVID-19 patients, renal replacement therapy, Continuous renal replacement therapy, COVID-19 patient, critically ill COVID-19 patients, Multicenter trial, replacement therapy, reduction, Serum IL-6, Research protocol, Trial registration, SpO2, blindness, continuous venovenous hemofiltration, Extracorporeal hemoadsorption, general condition, large prospective multicenter trials, Mean SpO2, Medical Sciences, mode, Peripheral capillary oxygen saturation, positive clinical improvement, reference number, severe coronavirus disease, state hospital, therapeutic approaches, website, Registered, participant, men, peripheral, FIVE, extracorporeal blood purification, IMPROVE, Result, enrolled, selected, evaluate, recruited, conducted, changed, therapeutic approach, IRCT20150704023055N2, randomization and blindness, 【제목키워드】 COVID-19, Patient, Blood purification, hemoadsorption,