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严重 COVID-19 病例中血液吸附治疗的文献综述:叙述性评论。

Literature Review of Hemadsorption Therapy in Severe COVID-19 Cases: a Narrative Review.

出版信息

Clin Lab. 2022 Feb 1;68(2). doi: 10.7754/Clin.Lab.2021.210839.

Abstract

BACKGROUND

A novel therapy for reducing the cytokines in the circulatory system used for severe COVID-19 cases was hemoperfusion or hemadsorption method. Although the hemoperfusion methods have been shown to be beneficial in the cytokine storm during influenza infection, it is not known to what extent it is successful for COVID-19 patients. Therefore, the purpose of this study is to review the studies on severe COVID-19 treated with the hemoperfusion methods.

METHODS

A literature search was conducted using the databases PubMed, Science Direct, and Springer databases. Since the included articles consisted of case reports, case series, and one controlled trial, only the mean of the analyzed data could be calculated.

RESULTS

Sixteen studies were included in the narrative review, including 86 patients with severe COVID-19. All the patients had hemoperfusion therapy with following cartridges: CytoSorb®, oXiris®, Biosky filter, SeaStar® CLR filter, HA280, HA330 Jafron©, and resin directed hemadsorption cartridges. Mortality rate, the mean of intubation time, duration in intensive care unit and hospital were 29%, 14.93 days, 17.21 days, and 31.7 days, respectively. The mean values of C-reactive protein and interleukin-6 decreased after hemoperfusion sessions (131.7 to 66.0, 527.5 to 334.7, respectively).

CONCLUSIONS

In this narrative review, it is demonstrated that hemadsorption therapy is an alternative salvage treatment method in critically ill COVID-19 patients, but the data must be supported by strong evidence.

摘要

背景

一种用于治疗重症 COVID-19 患者的新型疗法是血液灌流或血液吸附方法,用于减少循环系统中的细胞因子。虽然血液灌流方法已被证明在流感感染期间的细胞因子风暴中是有益的,但尚不清楚它对 COVID-19 患者的疗效如何。因此,本研究的目的是回顾使用血液灌流方法治疗重症 COVID-19 的研究。

方法

使用 PubMed、Science Direct 和 Springer 数据库进行文献检索。由于纳入的文章包括病例报告、病例系列和一项对照试验,因此只能计算分析数据的平均值。

结果

叙述性综述纳入了 16 项研究,共 86 例重症 COVID-19 患者。所有患者均接受血液灌流治疗,使用的器材包括 CytoSorb®、oXiris®、Biosky 过滤器、SeaStar® CLR 过滤器、HA280、HA330 Jafron© 和树脂导向血液吸附器材。死亡率、平均插管时间、重症监护病房和医院的住院时间分别为 29%、14.93 天、17.21 天和 31.7 天。血液灌流治疗后 C 反应蛋白和白细胞介素-6 的平均值降低(分别为 131.7 降至 66.0、527.5 降至 334.7)。

结论

在本叙述性综述中,血液吸附疗法是危重症 COVID-19 患者的一种替代挽救治疗方法,但数据必须有强有力的证据支持。

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