Cytosorb therapy in Covid-19 (CTC) patients requiring extracorporeal membrane oxygenation: a multicenter, retrospective registry
Song T, Hayanga J, Durham L, Garrison L, Supday A, Jaros M, Nelson P, Deliargyris, Moazami N. ISICEM 2021; Poster A155, P139
08/2021
Introduction: CytoSorb is a cytokine adsorption device that received FDA Emergency Use Authorization (EUA) for use in critically ill COVID-19 patients. The CTC Registry was established to collect patient-level data from U.S. centers using CytoSorb under the EUA. Methods:Consecutive patients on ECMO treated with CytoSorb were included. Retrospective data collection included demographics, comorbidities, COVID-19 medications, inflammatory biomarkers, and details on ECMO and CytoSorb use. Study follow-up was to hospital death or discharge. Primary outcome was ICU mortality. Comparisons between survivors and non-survivors were performed to evaluate predictors of mortality. Up-todate information from the international Extracorporeal Life Support Organization (ELSO) ECMO COVID-19 Registry was considered to help contextualize the results. Results: 52 ECMO patients treated under EUA from April 2020 to April 2021 were enrolled from 5 U.S. centers. Baseline characteristics were comparable to the ELSO Registry except for higher rates of obesity in the CTC cohort. ICU mortality rates in the CTC cohort were 17.3% at 30 days, 26.9% at 90 days, and 30.8% overall. Gender, age, baseline SOFA, baseline D-Dimer levels, and CytoSorb use between survivors and non-survivors are shown in the Table. Regression analyses suggested a borderline association between baseline D-Dimer levels and mortality, with 32% increase in the risk of death per 1 µg/mL increase (p=0.055). CytoSorb was generally well tolerated without any unanticipated device-related adverse events reported. Conclusion: Combined use of ECMO and CytoSorb in critically ill COVID-19 patients was associated with mortality rates that compared favorably to international benchmarks. Elevated baseline D-Dimer levels appeared to be associated with increased risk of mortality..
