Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Contrib Nephrol. 2023;200:192-200. doi: 10.1159/000527583. Epub 2023 Jun 1.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the global emergency outbreak disease that devastatingly affected world public health and the economy. The pathogenesis of severe SARS-CoV-2 infection in humans has been linked to a strong immunological response that leads to a hyperinflammatory state, or "cytokine storm," which is a sepsis-like state resulting in capillary leakage, microvascular and macrovascular thrombosis, and multiple organ destruction. In recent years, there have been several case series and few randomized controlled trials studying the effectiveness and risk of various hemoperfusion techniques in the context of severe SARS-CoV-2 infection including HA330, CytoSorb, Polymyxin, oXiris, and Seraph 100 cartridges. Because inconsistencies exist between studies, there is currently no consensus regarding the use of hemoperfusion in patients with SARS-CoV-2 infection. Further well-designed research is needed to validate its potential clinical benefits and identify the timing and characteristics of patients who might benefit the most.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引发了全球紧急疫情，严重影响了世界公共卫生和经济。人类严重 SARS-CoV-2 感染的发病机制与强烈的免疫反应有关，导致过度炎症状态，即“细胞因子风暴”，类似于败血症状态，导致毛细血管渗漏、微血管和大血管血栓形成以及多个器官损伤。近年来，有几项病例系列研究和少数随机对照试验研究了在严重 SARS-CoV-2 感染背景下各种血液灌流技术（包括 HA330、CytoSorb、多粘菌素、oXiris 和 Seraph 100 试剂盒）的有效性和风险。由于研究之间存在不一致，目前对于 SARS-CoV-2 感染患者使用血液灌流尚无共识。需要进一步设计良好的研究来验证其潜在的临床益处，并确定最受益的患者的时机和特征。
