Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Table 3 Studies determining efficacy of CytoSorb in coronavirus disease 2019 infection

Ref.	Study type	Population	Intervention	Outcomes
Alharthy et al[70], 2020	Retrospective case series	50 COVID-19 patients with AKI, ARDS, Sepsis and hyperinflammation	CytoSorb + CRRT [Survivors (n = 35) vs non survivors (n = 15)]	Decreased SOFA score, lactate levels, ferritin, D-dimers, CRP and IL-6 levels in th survivor group after 2 ± 1 sessions of CRRT + CytoSorb
Mehta et al[64], 2021	Case series	3 critically ill COVID-19 patients	CytoSorb hemoperfusion other prescribed medications (tocilizumab, antivirals, hydroxychloroquine, azithromycin)	Significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy; Reduction in CRP levels by 91.5%, 97.4% and 55.75%, respectively; Improvement in MAP by 18%, 23% and 17% by 7th day post therapy
Nassiri et al[71], 2021	Retrospective case series	26 COVID-19 patients with ARDS	CytoSorb hemadsorption therapy	21 patients survived; Significant decrease in NE requirement; PCT, CRP and ferritin reduced post therapy; Significant improvement in SOFA scores; Therapy was well tolerated
Paisey et al[72], 2021	Retrospective case series	15 severely ill COVID-19 patients	CytoSorb hemadsorption therapy	Adjunctive treatment with CytoSorb lead to reduction in ferritin, CRP, PCT and lactate levels
Song et al[73], 2021	Multicenter observational study	52 ICU COVID -19 patients on ECMO	ECMO + CytoSorb hemadsorption therapy	ICU mortality was 17.3% on day 30, 26.9% on day 90, and 30.8% at final follow up of 143 d; Lower baseline D-Dimer levels were observed among survivors (2.3 ± 2.5 vs 19.8 ± 32.2 µg/mL) compared to non survivors; Borderline association observed between baseline D-Dimer levels and mortality with a 32% increase in risk of death per 1 µg/mL increase

COVID-19: Coronavirus disease 2019; CRRT: Continuous renal replacement therapy; SOFA: Sequential organ failure assessment; CRP: C-reactive protein; IL: Interleukin; AKI: Acute kidney injury; ARDS: Acute respiratory distress syndrome; MAP: Mean arterial pressure; NE: Norepinephrine; ECMO: Extracorporeal membrane oxygenation.