The Outcome of Hemoperfusion as an Adjuvant Therapy in Patients with Severe COVID-19 Pneumonia
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Abstract
Background: Coronavirus disease-2019 (COVID-19) pneumonia can result in cytokine release syndrome and a high mortality rate. In addition to anti-viral medications, immunomodulators, and systemic corticosteroids, cytokine removal therapy, also known as hemoperfusion, might have a role in improving patient outcomes.
Methods: This is a retrospective observational study of patients with severe COVID-19 pneumonia who received hemoperfusion using HA 330® in addition to conventional treatment compared to conventional treatment alone during May 2021 – June 2022. The primary outcome was the 28-day survival rate.
Results: 155 patients were included; 98 patients in the hemoperfusion group; and 57 patients in the conventional treatment group. Patients who received hemoperfusion had a higher Sequential Organ Failure Assessment score (10±3.3 vs. 7±2.9; p<0.001). There was no significant difference in the 28-day survival rate between the two groups (54.1% vs. 42.1%; p=0.198). Hemoperfusion for 24-48 hours significantly improved PaO2/FiO2 ratio (P=0.001) and reduced high-sensitivity C-reactive protein (p<0.001) and ferritin levels (P=0.003). Acute kidney injury was associated with an increased risk of 28-day mortality (Hazard ratio (95% confidence interval): 4.72 (2.87 to 7.77); p<0.001). The most common cause of death was bacterial pneumonia.
Conclusions: Hemoperfusion using HA330® was not associated with an improvement in 28-day survival in patients with severe COVID-19 pneumonia during the delta variant outbreak.
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