Cytokine Filter Experience in Covid-19 Treatment; A Single Center Study

Abstract

Aim: Several studies state that the primary underlying mechanism of severe COVID-19 cases includes the hyperimmune response triggered following SARS-CoV-2 infections and the subsequent cytokine storm. The study aims to examine the effects of cytokine filters on patients with COVID-19 who developed cytokine storms. Material and Methods: This is a retrospective, cross-sectional study. All the patients included in the study had tested positive for COVID-19 in their real-time polymerase chain reaction test. The study included patients with COVID-19 who developed cytokine storms and were treated in the ICU. The patients were divided into two groups those who applied cytokine filter or not. The demographic data and laboratory findings of the patients were recorded. The patient outcomes were categorized as discharged or deceased. Results: The study included 149 patients. Patients’ mean age was 56±29 years, and 125 (83.9%) patients were male. A significant decrease was detected in the levels of fibrinogen, ferritin, lymphocyte count, and CRP after cytokine filtration (p <0.001, <0.001, 0.031, and <0.001, respectively). Age, d-dimer, and lymphocyte count were found independent factors for discharge. Conclusion: The blood filtration method has been found to be useful in the hyperimmune response when administered following early diagnosis in selected cases. When administered following early diagnosis in selected cases, the method can be beneficial in supplementing the effectiveness of primary therapies and preventing secondary cytokine release complications as it controls hyperinflammation.

Keywords

• cytokine storm
• COVID-19
• therapeutics
• interleukin
• blood

Covid-19 Tedavisinde Sitokin Filtresi Deneyimi;Tek Merkezli Bir Çalışma

Öz

Amaç: Yapılan birçok çalışmada şiddetli COVID-19 vakalarının altında yatan ana mekanizmanın, enfeksiyonu takiben tetiklenen hiperimmün yanıt ve ardından gelişen sitokin fırtınası olduğu belirtilmektedir. Çalışmamız sitokin fırtınası gelişen COVID-19 hastalarında, sitokin filtrelerisinin tedavideki etkilerini incelemeyi amaçlamaktadır. Materyal ve Metot: Çalışmamız retrospektif, kesitsel bir çalışmadır. Çalışmaya dahil edilen tüm hastaların gerçek zamanlı polimeraz zincir reaksiyonu ile COVID-19 testi pozitif olan hastalardan oluşmaktadır. Çalışma, sitokin fırtınaları geliştiren ve yoğun bakım ünitesinde tedavi edilen COVID-19 hastalarını içeriyordu. Hastalar sitokin filtresi uygulanan ve uygulanmayanlar olmak üzere iki gruba ayrıldı. Hastaların demografik verileri ve laboratuvar bulguları kaydedildi. Hasta sonuçları taburcu veya ölen olarak kategorize edildi. Bulgular: Çalışmaya 149 hasta dahil edildi. Hastaların yaş ortalaması 56±29 yıl olup 125 (%83,9) hasta erkekti. Sitokin filtrasyonu sonrası fibrinojen, ferritin, lenfosit sayısı ve CRP düzeylerinde anlamlı düşüş tespit edildi (sırasıyla p <0,001, <0,001, 0,031 ve <0,001). Yaş, d-dimer ve lenfosit sayısının taburculuk için bağımsız faktörler olduğu tespit edildi. Sonuç: Seçilmiş olgularda ve erken tanı sonrası kan filtrasyon yöntemlerinin uygulanması hiperimmün yanıt tedavisinde faydalı olduğu bulunmuştur. Seçilmiş vakalarda erken tanının ardından uygulandığında bu yöntem, hiperinflamasyonu kontrol altına aldığı için birincil tedavilerin etkinliğini desteklemede ve sitokin salınımına sekonder gelişen komplikasyonları önlemede faydalı olabilir.

Anahtar Kelimeler

• sitokin fırtınası
• Covid-19
• terapötik
• interlökin
• kan

Kaynakça

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