Sequential Extracorporeal Blood Purification Is Associated with Prolonged Survival among ICU Patients with COVID-19 and Confirmed Bacterial Superinfection

Abstract

<b><i>Introduction:</i></b> This study investigates the impact of sequential extracorporeal treatments with oXiris^® or CytoSorb^® plus Seraph-100^® on the clinical and laboratory parameters of critically ill COVID-19 patients with bacterial superinfection. <b><i>Methods:</i></b> Patients admitted to the intensive care unit with COVID-19, bacterial superinfection, and undergoing blood purification (BP) were enrolled in this prospective, single-center, observational study. “standard BP” with oXiris^® or CytoSorb^® were used in 35 COVID-19 patients with bacterial infection. Seraph-100^® was added in 33 patients when available serially in the same oXiris^® circuit or as sequential treatment with CytoSorb^® as a sequential BP. <b><i>Results:</i></b> A significant reduction in SOFA score 3 days after treatment was observed in patients undergoing sequential BP (11.3 vs. 8.17, <i>p</i> &lt; 0.01) compared to those undergoing “standard BP” (11.0 vs. 10.3, <i>p</i> &gt; 0.05). The difference between the observed and expected mortality rate based on APACHE IV was greater in the sequential BP group (42.4% vs. 81.7%, <i>p</i> &lt; 0.001) than the “standard BP” (74.2% vs. 81.7%, <i>p</i> &gt; 0.05). Patients treated with sequential BP had a longer survival than those treated with “standard BP” (22.4 vs. 18.7 months; <i>p</i> &lt; 0.001). <b><i>Conclusions:</i></b> The sequential approach may enhance the positive effect of BP on organ dysfunction among critically ill patients with COVID-19 and bacterial superinfection.