Impact of extracorporeal hemadsorption on mortality in critically ill COVID-19 patients in the intensive care unit

Author:

Çakin Özlem1ORCID,Yüce Aktepe Melike1,Harmandar Orbay2,Deveci Kamil3,Esra Yildirim Özlem4,Kurtoğlu Erdal5

Affiliation:

1. Department of Internal Medicine Intensive Care Unit, Akdeniz University Faculty of Medicine, Antalya, Turkey

2. Department of Internal Medicine Intensive Care Unit, Antalya Training and Research Hospital, Antalya, Turkey

3. Department of Internal Medicine Intensive Care Unit, Kayseri City Training and Research Hospital, Kayseri, Turkey

4. Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey

5. Department of Haematology, Antalya Training and Research Hospital, Antalya, Turkey

Abstract

Background: The consequences of COVID-19, such as respiratory failure and mortality, require the search for fast and effective solutions. The aim of this retrospective study is to determine the effect of extracorporeal hemadsorption on mortality in severe COVID-19 cases hospitalized in the intensive care unit (ICU). Methods: Our study is retrospective, single-center, and observational. The study included ICU patients diagnosed with COVID-19 who received extracorporeal hemadsorption treatment between March 2020 and December 2020. Effects on mortality were examined by comparing pre- and post-hemadsorption values. Results: Seventeen patients were included in the study. The mortality rate in the study was 64.7%. After hemadsorption, an increase was observed in the lymphocyte numbers, APACHE-II, and SOFA values of the patients ( p = 0.026, 0.043, and 0.033; respectively). A significant decrease was observed in CRP and fibrinogen levels ( p = 0.003 and 0.005; respectively). In the non-surviving patient group, APACHE-II, SOFA, and procalcitonin values were found to be high before and after the procedure ( p = 0.002, 0.048, and 0.06; respectively). Conclusion: In COVID-19 patients, APACHE-II and SOFA scores may be useful in predicting the effectiveness of extracorporeal hemadsorption. Our study found that patients with higher APACHE-II and SOFA scores at baseline had a higher mortality rate after hemadsorption. These findings show that the use of intensive care scoring systems may be useful in determining which patients should receive extracorporeal hemadsorption and that hemadsorption should be performed in the early stages of the disease.

Publisher

SAGE Publications

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