Safari Saeid, Salimi Alireza, Zali Alireza, Jahangirifard Alireza, Bastanhagh Ehsan, Aminnejad Reza, Dabbagh Ali, Lotfi Amir Hossein, Saeidi Mohammad
Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2020 Aug 22;8(1):e67. eCollection 2020.
The 2019 novel coronavirus (officially known as severe acute respiratory syndrome coronavirus 2, SARS-CoV2) was first found in Wuhan, China. On February 11, 2020, the World Health Organization (WHO) has declared the outbreak of the disease caused by SARS-CoV2, named coronavirus disease 2019 (COVID-19), as an emergency of international concern. Based on the current epidemiological surveys, some COVID-19 patients with severe infection gradually develop impairment of the respiratory system, acute kidney injury (AKI), multiple organ failure, and ultimately, death. Currently, there is no established pharmacotherapy available for COVID-19. As seen in influenza, immune damage mediated by excessive production of inflammatory mediators contributes to high incidence of complications and poor prognosis. Thus, removal or blocking the overproduction of these mediators potentially aids in reducing the deleterious cytokine storm and improving critically ill patients' outcomes. Based on previous experience of blood purification to treat cytokine storm syndrome (CSS) in severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), here we aimed to review the current literature on extracorporeal hemoperfusion as a potential therapeutic option for CSS-associated conditions, with a focus on severe COVID-19.
2019新型冠状病毒（官方名称为严重急性呼吸综合征冠状病毒2，即SARS-CoV2）最早在中国武汉被发现。2020年2月11日，世界卫生组织（WHO）宣布由SARS-CoV2引起的疾病爆发，即冠状病毒病2019（COVID-19），为国际关注公共卫生紧急事件。根据目前的流行病学调查，一些重症COVID-19患者会逐渐出现呼吸系统损伤、急性肾损伤（AKI）、多器官功能衰竭，最终导致死亡。目前，尚无针对COVID-19的既定药物治疗方法。正如在流感中所见，炎症介质过度产生介导的免疫损伤导致并发症高发和预后不良。因此，清除或阻断这些介质的过度产生可能有助于减少有害的细胞因子风暴并改善重症患者的预后。基于以往血液净化治疗严重急性呼吸综合征（SARS）和中东呼吸综合征（MERS）中细胞因子风暴综合征（CSS）的经验，我们旨在综述当前关于体外血液灌流作为CSS相关病症潜在治疗选择的文献，重点关注重症COVID-19。
