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Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19

In this study, we aimed to determine whether continuous renal replacement therapy (CRRT) with oXiris filter may alleviate cytokine release syndrome (CRS) in non-AKI patients with severe and critical coronavirus disease 2019 (COVID-19). A total of 17 non-AKI patients with severe and critical COVID-19...

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Autores principales: Kang, Kai, Luo, Yunpeng, Gao, Yang, Zhang, Jiannan, Wang, Changsong, Fei, Dongsheng, Yang, Wei, Meng, Xianglin, Ye, Ming, Gao, Yan, Liu, Haitao, Du, Xue, Ji, Yuanyuan, Wei, Jieling, Xie, Wanqiu, Wang, Jun, Zhao, Mingyan, Yu, Kaijiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8854969/
https://www.ncbi.nlm.nih.gov/pubmed/35185571
http://dx.doi.org/10.3389/fphar.2022.817793
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author Kang, Kai
Luo, Yunpeng
Gao, Yang
Zhang, Jiannan
Wang, Changsong
Fei, Dongsheng
Yang, Wei
Meng, Xianglin
Ye, Ming
Gao, Yan
Liu, Haitao
Du, Xue
Ji, Yuanyuan
Wei, Jieling
Xie, Wanqiu
Wang, Jun
Zhao, Mingyan
Yu, Kaijiang
author_facet Kang, Kai
Luo, Yunpeng
Gao, Yang
Zhang, Jiannan
Wang, Changsong
Fei, Dongsheng
Yang, Wei
Meng, Xianglin
Ye, Ming
Gao, Yan
Liu, Haitao
Du, Xue
Ji, Yuanyuan
Wei, Jieling
Xie, Wanqiu
Wang, Jun
Zhao, Mingyan
Yu, Kaijiang
author_sort Kang, Kai
collection PubMed
description In this study, we aimed to determine whether continuous renal replacement therapy (CRRT) with oXiris filter may alleviate cytokine release syndrome (CRS) in non-AKI patients with severe and critical coronavirus disease 2019 (COVID-19). A total of 17 non-AKI patients with severe and critical COVID-19 treated between February 14 and March 26, 2020 were included and randomly divided into intervention group and control group according to the random number table. Patients in the intervention group immediately received CRRT with oXiris filter plus conventional treatment, while those in the control group only received conventional treatment. Demographic data were collected and collated at admission. During ICU hospitalization, the concentrations of circulating cytokines and inflammatory chemokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were quantitatively measured daily to reflect the degree of CRS induced by SARS-CoV-2 infection. Clinical data, including the severity of COVID-19 white blood cell count (WBC), neutrophil proportion (NEUT%), lymphocyte count (LYMPH), lymphocyte percentage (LYM%), platelet (PLT), C-reaction protein (CRP), high sensitivity C-reactive protein (hs-CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin (ALB), serum creatinine (SCr), D-Dimer, fibrinogen (FIB), IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, number of hospital days and sequential organ failure assessment (SOFA) score were obtained and collated from medical records, and then compared between the two groups. Age, and SCr significantly differed between the two groups. Besides the IL-2 concentration that was significantly lower on day 2 than that on day 1 in the intervention group, and the IL-6 concentrations that were significantly higher on day 1, and day 2 in the intervention group compared to the control group, similar to the IL-10 concentration on day 5, there were no significant differences between the two groups. To sum up, CRRT with oXiris filter may not effectively alleviate CRS in non-AKI patients with severe and critical COVID-19. Thus, its application in these patients should be considered with caution to avoid increasing the unnecessary burden on society and individuals and making the already overwhelmed medical system even more strained (IRB number: IRB-AF/SC-04).
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spelling pubmed-88549692022-02-19 Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19 Kang, Kai Luo, Yunpeng Gao, Yang Zhang, Jiannan Wang, Changsong Fei, Dongsheng Yang, Wei Meng, Xianglin Ye, Ming Gao, Yan Liu, Haitao Du, Xue Ji, Yuanyuan Wei, Jieling Xie, Wanqiu Wang, Jun Zhao, Mingyan Yu, Kaijiang Front Pharmacol Pharmacology In this study, we aimed to determine whether continuous renal replacement therapy (CRRT) with oXiris filter may alleviate cytokine release syndrome (CRS) in non-AKI patients with severe and critical coronavirus disease 2019 (COVID-19). A total of 17 non-AKI patients with severe and critical COVID-19 treated between February 14 and March 26, 2020 were included and randomly divided into intervention group and control group according to the random number table. Patients in the intervention group immediately received CRRT with oXiris filter plus conventional treatment, while those in the control group only received conventional treatment. Demographic data were collected and collated at admission. During ICU hospitalization, the concentrations of circulating cytokines and inflammatory chemokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were quantitatively measured daily to reflect the degree of CRS induced by SARS-CoV-2 infection. Clinical data, including the severity of COVID-19 white blood cell count (WBC), neutrophil proportion (NEUT%), lymphocyte count (LYMPH), lymphocyte percentage (LYM%), platelet (PLT), C-reaction protein (CRP), high sensitivity C-reactive protein (hs-CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin (ALB), serum creatinine (SCr), D-Dimer, fibrinogen (FIB), IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, number of hospital days and sequential organ failure assessment (SOFA) score were obtained and collated from medical records, and then compared between the two groups. Age, and SCr significantly differed between the two groups. Besides the IL-2 concentration that was significantly lower on day 2 than that on day 1 in the intervention group, and the IL-6 concentrations that were significantly higher on day 1, and day 2 in the intervention group compared to the control group, similar to the IL-10 concentration on day 5, there were no significant differences between the two groups. To sum up, CRRT with oXiris filter may not effectively alleviate CRS in non-AKI patients with severe and critical COVID-19. Thus, its application in these patients should be considered with caution to avoid increasing the unnecessary burden on society and individuals and making the already overwhelmed medical system even more strained (IRB number: IRB-AF/SC-04). Frontiers Media S.A. 2022-02-04 /pmc/articles/PMC8854969/ /pubmed/35185571 http://dx.doi.org/10.3389/fphar.2022.817793 Text en Copyright © 2022 Kang, Luo, Gao, Zhang, Wang, Fei, Yang, Meng, Ye, Gao, Liu, Du, Ji, Wei, Xie, Wang, Zhao and Yu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Kang, Kai
Luo, Yunpeng
Gao, Yang
Zhang, Jiannan
Wang, Changsong
Fei, Dongsheng
Yang, Wei
Meng, Xianglin
Ye, Ming
Gao, Yan
Liu, Haitao
Du, Xue
Ji, Yuanyuan
Wei, Jieling
Xie, Wanqiu
Wang, Jun
Zhao, Mingyan
Yu, Kaijiang
Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title_full Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title_fullStr Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title_full_unstemmed Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title_short Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19
title_sort continuous renal replacement therapy with oxiris filter may not be an effective resolution to alleviate cytokine release syndrome in non-aki patients with severe and critical covid-19
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8854969/
https://www.ncbi.nlm.nih.gov/pubmed/35185571
http://dx.doi.org/10.3389/fphar.2022.817793
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