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EXCLUSIVE. Along with 20 other Romanian patients in critical condition, His Eminence Pimen received a revolutionary treatment for COVID-19: blood filtration against the cytokine storm Worldwide, 750 patients were treated this way, according to CytoSorbents, the manufacturer of the most widely used filter. Germany is the country that uses the procedure most often, and the USA has recently authorized it. In Romania, it is done in Timisoara, Cluj and Bucharest, but only in the case of a few dozen patients. By Alexandra Nistoroiu , Catalin Tolontan , Sunday, May 10, 2020, 3:01 p.m. In the case of His Eminence Pimen, the high prelate of Suceava, the method was used in addition to that of convalescent plasma , which is a different treatment from blood filtration. CytoSorb is a blood filtration product and a treatment used experimentally in severe cases of COVID-19, in countries such as Germany, China, Italy and Israel. Romania quickly adopted the procedure, which in its complete formula uses three kits, with a value of approximately 2,000 euros each. In the United States, the treatment was approved in April for emergency use by the FDA (US Drug Administration). What is blood filtration? The therapy itself is based on an extracorporeal purification of the blood that reduces the excessive level of inflammatory mediators. Basically, the blood filtration solution, CytoSorb is one of the trade names, but there are others, it can be used with standard hemodialysis, hemofiltration devices or ECMO devices that are found in hospitals around the world. The goal is to reduce the systemic inflammatory response while keeping the physiological immune response intact. RECOMMENDATIONS EXCLUSIVE. Along with 20 other Romanian patients in critical condition, PSI received a revolutionary treatment for COVID-19: blood filtration against cytokine storm This method of "cleansing the blood" lowers the level of cytokines. It has already been shown to be useful in cases of sepsis, seasonal flu, endocarditis in heart patients, exacerbations of chronic kidney disease, etc. Therefore, the idea to be used in COVID-19 came at a time when hospitals realized that the virus causes a sometimes disproportionate immune response. With the help of this therapy, the danger of life and death represented by the "cytokine storm" is avoided . Cytokines are not completely eliminated, but are reduced to a level that is no longer toxic. 10 patients treated in Timisoara, 3 in Cluj "Yes, Romania quickly applied this method, which is a superior technology", explains Dorel Sandesc, president of the Romanian Society of Intensive Care. Even if the filtering is technically easy, a filter, a cartridge is inserted, but there are things that must be taken into account.Because it not only eliminates the excess of cytokines, but can also eliminate the cytokines needed for an immune response of the body. Dr. Dorel Sandesc: Sandesc confirmed that "10 patients with COVID-19 were treated in this way in Timi?oara and 3 in Cluj, and the treatment is also performed in Bucharest". What happens to patients treated with blood filtration? "Since the administration of the first kit, there is usually an improvement in the condition. Basically, the goal is for critical patients in ATI not to be intubated ", explains a specialist from the pharmaceutical industry. Cytokines, molecules that transmit information between different cells, are used by the immune system as an alarm signal in the event of an attack by a pathogen. When activated, cytokines recruit immune cells and direct them to the site of infection. In the case of an aggressive virus, such as the new coronavirus, the immune response can be disproportionate. The worst cases of COVID-19 seem to be associated with this excessive reaction of the immune system, rather than the infection itself. New research suggests that cytokine "storms" may lower T cell count, a type of white blood cell that plays an important role in immune responses, affecting the severity of the disease. Romania has treated as many patients as the US with the COVID filtration method According to a press release from the company that produces the most used device worldwide, Cutosorn, so far 750 patients with COVID-19 have been treated worldwide, mainly in China, Italy, Germany. In the United States, 25 patients were treated, and a large number of them escaped mechanical ventilation or the ECMO procedure, the company says . Several clinical trials are currently being performed in patients with COVID-19 to test the efficacy of this type of device in severe COVID-19 infections, especially in Germany, which, according to the manufacturer, makes the most use of this method. Like any other treatment used in the fight against the new coronavirus, it is also experimental and supportive, not proven - because for such a new disease it is impossible to have scientifically proven treatments in all respects. Used for other suffering in the last 6 years "I think I first used this therapy in 2014, in intensive care at the University," says Elena Copaciu, ATI primary care physician at the University Hospital of Bucharest. It is used in patients with a hyperimmune response, usually in severe septic conditions.There are patients who still live today and have been saved thanks to this technique. Elena Copaciu: In the case of COVID-19, "the virus may not even be there, but, instead of infection, it remains the hyperimmune reaction that destroys the body and must be treated," explains doctor Elena Copaciu. Filtration therapy is settled on the national ATI program. The National Institute of Infectious Diseases "Matei Bals" confirmed for Libertatea the use of the treatment. "CytoSorb has been used in a few cases, under 10. There have been no funding issues, but patients should be instructed to do so. That's all they had ", Catalin Apostolescu, the spokesman from" Bals ", declared for Libertatea. We have been using this procedure for a long time, long before COVID-19 appeared, it is not a new thing.It is really very expensive.A filter can cost between 2,000 and 4,000 euros and, depending on the patient's condition, you may need two to five filters.Costs dry you up, but to save a man's life, it's worth it. Dr. Catalin Apostolescu: Libertatea asked Catalin Apostolescu if he could confirm that His Eminence Pimen was treated with CytoSorb: “No comment. Details about a patient's treatment are confidential. "
