Use of CytoSorb therapy to treat critically ill coronavirus disease 2019 patients: a case series
Yatin Mehta et al. J Med Case Rep. 2021.
Free article
Hide details
J Med Case Rep
. 2021 Sep 18;15(1):476.
doi: 10.1186/s13256-021-03021-y.
Authors
Yatin Mehta 1 , Chitra Mehta 2 , Saurabh Nanda 2 , Gaurav Kochar 2 , Joby V George 2 , Manish Kumar Singh 3
Affiliations
1 Institute of Critical care and Anesthesia, Medanta The Medicity, Sect 38, Gurgaon, Haryana, India. yatinmehta@hotmail.com.
2 Institute of Critical care and Anesthesia, Medanta The Medicity, Sect 38, Gurgaon, Haryana, India.
3 Medanta Institute of Education and Research, Medanta The Medicity, Sect 38, Gurgaon, Haryana, India.
PMID: 34535189
DOI: 10.1186/s13256-021-03021-y
Full text links
Cite
Abstract
Background: Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019.
Case presentation: This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients' average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy.
Conclusions: All three patients improved clinically and survived.
Keywords: COVID-19; Critical illness; CytoSorb; Cytokines; Intensive care unit (ICU).
