Vásquez-Torres J, Dávila-Collado R, Abdalah-Perez L, Jarquin-Duran O, Latino JS, Espinoza JL. Beyond conventional care: The therapeutic potential of hemoperfusion in severe COVID-19. World J Crit Care Med 2024; 13(4): 97631 [PMID: 39655296 DOI: 10.5492/wjccm.v13.i4.97631]
Corresponding Author of This Article
Jorge Luis Espinoza, MD, PhD, Professor, Faculty of Health Sciences, Kanazawa University, Kodatsuno 5-11-18, Kanazawa 920942, Japan. luis@staff.kanazawa-u.ac.jp
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Dec 9, 2024; 13(4): 97631 Published online Dec 9, 2024. doi: 10.5492/wjccm.v13.i4.97631
Beyond conventional care: The therapeutic potential of hemoperfusion in severe COVID-19
John Vásquez-Torres, Ramses Dávila-Collado, Leyla Abdalah-Perez, Oscar Jarquin-Duran, José Santos Latino, Jorge Luis Espinoza
John Vásquez-Torres, Leyla Abdalah-Perez, Kidney and Hemodialysis Unit, Baptist Hospital of Nicaragua, Managua 2300, Nicaragua
Ramses Dávila-Collado, Oscar Jarquin-Duran, José Santos Latino, Emergency Medicine, Baptist Hospital of Nicaragua, Managua 2300, Nicaragua
Jorge Luis Espinoza, Faculty of Health Sciences, Kanazawa University, Kanazawa 920942, Japan
Co-first authors: John Vásquez-Torres and Ramses Dávila-Collado.
Author contributions: Vasquez-Torres J, Davila-Collado R contributed to data collection, data entry, and writing; Abdalah-Perez L contributed to data collection, data entry, and critical revision; Jarquin-Duran O contributed to data collection and data entry; Latino JS contributed to data collection and provided methodological support; Espinoza JL designed the research and contributed to conceptualization, writing, and review. Vasquez-Torres J and Davila-Collado R contributed equally to this work as co-first authors.
Institutional review board statement: Institutional Review Board approval was not required for this observational, retrospective study of routinely transmitted patient information.
Informed consent statement: Written informed consent for the report of this study was waived owing to the rapid emergence of cases during the peak of the pandemic.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: Data are available from the authors upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jorge Luis Espinoza, MD, PhD, Professor, Faculty of Health Sciences, Kanazawa University, Kodatsuno 5-11-18, Kanazawa 920942, Japan. luis@staff.kanazawa-u.ac.jp
Received: June 4, 2024 Revised: August 26, 2024 Accepted: September 12, 2024 Published online: December 9, 2024 Processing time: 149 Days and 1.7 Hours
Abstract
BACKGROUND
Hemoperfusion (HP) is an extracorporeal blood purification modality utilized to remove small- to medium-sized molecules, such as toxins and cytokines, that are difficult to remove by conventional hemodialysis. In clinical practice, HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and sepsis.
AIM
To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019 (COVID-19) who received HP.
METHODS
Here, we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic. A review of the literature was also performed.
RESULTS
HP was well-tolerated, and after an average of three sessions, respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most patients. Ten patients were discharged alive. Our literature search identified a total of 20 studies (873 patients) in which HP was used for COVID-19. Nine studies reported improvements in respiratory parameters, and 13 studies (438 patients in total) reported better survival rates in patients undergoing HP.
CONCLUSION
HP was well-tolerated in patients with severe COVID-19, and most studies reported improved clinical parameters, including better survival rates, when HP was used in patients with severe COVID-19. Further research, especially prospective studies, is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases, such as those with COVID-19 or severe sepsis.
Core Tip: Hemoperfusion (HP) is an extracorporeal blood purification therapy that is increasingly being utilized in the intensive care unit. We show that HP improved respiratory and cardiovascular parameters and various inflammatory markers in a series of coronavirus disease 2019 patients in critical condition, in agreement with various reports from the literature. However, the absence of data from randomized controlled trials and a lack of consensus guidelines remain important issues for the utilization of HP in clinical practice.
