Pape Anke, Kielstein Jan T, Krüger Tillman, Fühner Thomas, Brunkhorst Reinhard
Kuratorium für Dialyse und Nierentransplantation, Pelikanplatz, Hannover, Germany.
Department of Nephrology, Angiology and Rheumatology, KRH Klinikum Siloah, Hannover, Germany.
TH Open. 2021 Apr 14;5(2):e134-e138. doi: 10.1055/s-0041-1727121. eCollection 2021 Apr.
The coronavirus disease 2019 (COVID-19) pandemic has a serious impact on health and economics worldwide. Even though the majority of patients present with moderate and mild symptoms, yet a considerable portion of patients need to be treated in the intensive care unit. Aside from dexamethasone, there is no established pharmacological therapy. Moreover, some of the currently tested drugs are contraindicated for special patient populations like remdesivir for patients with severely impaired renal function. On this background, several extracorporeal treatments are currently explored concerning their potential to improve the clinical course and outcome of critically ill patients with COVID-19. Here, we report the use of the Seraph 100 Microbind Affinity filter, which is licensed in the European Union for the removal of pathogens. Authorization for emergency use in patients with COVID-19 admitted to the intensive care unit with confirmed or imminent respiratory failure was granted by the U.S. Food and Drug Administration on April 17, 2020. A 53-year-old Caucasian male with a severe COVID-19 infection was treated with a Seraph Microbind Affinity filter hemoperfusion after clinical deterioration and commencement of mechanical ventilation. The 70-minute treatment at a blood flow of 200 mL/minute was well tolerated, and the patient was hemodynamically stable. The hemoperfusion reduced D-dimers dramatically. This case report suggests that the use of Seraph 100 Microbind Affinity filter hemoperfusion might have positive effects on the clinical course of critically ill patients with COVID-19. However, future prospective collection of data ideally in randomized trials will have to confirm whether the use of Seraph 100 Microbind Affinity filter hemoperfusion is an option of the treatment for COVID-19.
2019年冠状病毒病(COVID-19)大流行对全球健康和经济产生了严重影响。尽管大多数患者表现为中度和轻度症状,但仍有相当一部分患者需要在重症监护病房接受治疗。除地塞米松外,尚无既定的药物治疗方法。此外,一些目前正在测试的药物对特殊患者群体是禁忌的,例如肾功能严重受损患者禁用瑞德西韦。在此背景下,目前正在探索几种体外治疗方法,以了解其改善COVID-19危重症患者临床病程和结局的潜力。在此,我们报告了Seraph 100微结合亲和过滤器的使用情况,该过滤器在欧盟被许可用于清除病原体。2020年4月17日,美国食品药品监督管理局批准其在确诊或即将出现呼吸衰竭的重症监护病房COVID-19患者中紧急使用。一名53岁的患有严重COVID-19感染的白人男性在临床病情恶化并开始机械通气后,接受了Seraph微结合亲和过滤器血液灌流治疗。在血流量为200毫升/分钟的情况下进行了70分钟的治疗,患者耐受性良好,血流动力学稳定。血液灌流使D-二聚体显著降低。本病例报告表明,使用Seraph 100微结合亲和过滤器血液灌流可能对COVID-19危重症患者的临床病程产生积极影响。然而,未来理想情况下在随机试验中进行前瞻性数据收集,将必须确认使用Seraph 100微结合亲和过滤器血液灌流是否是治疗COVID-19的一种选择。