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.
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.
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使用 oXiris 过滤器进行连续肾脏替代治疗可能无法有效缓解患有严重和危重症 COVID-19 的非 AKI 患者的细胞因子释放综合征
DOI：
10.3389/fphar.2022.817793
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发表时间：
2022
影响因子：
5.6
通讯作者：
Yu K
中科院分区：
文献类型：
--
作者：
Kang K;Luo Y;Gao Y;Zhang J;Wang C;Fei D;Yang W;Meng X;Ye M;Gao Y;Liu H;Du X;Ji Y;Wei J;Xie W;Wang J;Zhao M;Yu K
在本研究中，我们旨在确定使用oXiris滤器的连续性肾脏替代治疗（CRRT）是否可以缓解2019年冠状病毒病（COVID-19）重度和危重非AKI患者的细胞因子释放综合征（CRS）。纳入2020年2月14日至3月26日期间接受治疗的17例非AKI的COVID-19重症和危重患者，按照随机数字表随机分为干预组和对照组。干预组患者立即接受oXiris滤过器CRRT加常规治疗，对照组仅接受常规治疗。在入院时收集并整理人口统计学数据。在ICU住院期间，每天定量测定循环细胞因子和炎性趋化因子的浓度，包括IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ，以反映SARS-CoV-2感染诱导的CRS的程度。临床数据，包括COVID-19严重程度白色血细胞计数（WBC）、中性粒细胞比例（NEUT%）、淋巴细胞计数（LYMPH）、淋巴细胞百分比（LYM%）、血小板（PLT）、C反应蛋白（CRP）、超敏C反应蛋白（hs-CRP）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TB）、白蛋白（ALB）、血清肌酐（SCr），比较两组患者的D-二聚体、纤维蛋白原（FIB）、白细胞介素2（IL-2）、白细胞介素4（IL-4）、白细胞介素6（IL-6）、白细胞介素10（IL-10）、肿瘤坏死因子α（TNF-α）、干扰素γ（IFN-γ）、住院天数及序贯器官衰竭评分（SOFA）。两组之间的年龄和SCr存在显着差异。除干预组第2天IL-2浓度显著低于第1天，干预组第1、2天IL-6浓度显著高于对照组，与第5天IL-10浓度相似外，两组间无显著差异。综上所述，采用oXiris滤过器的CRRT可能无法有效缓解非AKI重度和危重COVID-19患者的CRS。因此，应谨慎考虑在这些患者中的应用，以避免增加社会和个人的不必要负担，并使本已不堪重负的医疗系统更加紧张（IRB编号：IRB-AF/SC-04）。
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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DOI：
10.1016/j.cmi.2020.09.045
发表时间：
2021-01
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Liu Z;Li X;Fan G;Zhou F;Wang Y;Huang L;Yu J;Yang L;Shang L;Xie K;Xu J;Huang Z;Gu X;Li H;Zhang Y;Wang Y;Huang Z;Cao B
通讯作者：
Cao B
影响因子：
10.9
作者：
Constantinescu, Catalin;Pasca, Sergiu;Tomuleasa, Ciprian
通讯作者：
Tomuleasa, Ciprian
影响因子：
82.9
作者：
Del Valle DM;Kim-Schulze S;Huang HH;Beckmann ND;Nirenberg S;Wang B;Lavin Y;Swartz TH;Madduri D;Stock A;Marron TU;Xie H;Patel M;Tuballes K;Van Oekelen O;Rahman A;Kovatch P;Aberg JA;Schadt E;Jagannath S;Mazumdar M;Charney AW;Firpo-Betancourt A;Mendu DR;Jhang J;Reich D;Sigel K;Cordon-Cardo C;Feldmann M;Parekh S;Merad M;Gnjatic S
通讯作者：
Gnjatic S
DOI：
10.1056/nejmoa2105000
发表时间：
2021-06-10
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hacisuleyman E;Hale C;Saito Y;Blachere NE;Bergh M;Conlon EG;Schaefer-Babajew DJ;DaSilva J;Muecksch F;Gaebler C;Lifton R;Nussenzweig MC;Hatziioannou T;Bieniasz PD;Darnell RB
通讯作者：
Darnell RB
DOI：
10.1186/s13054-020-03398-0
发表时间：
2020-12-14
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bermejo-Martin JF;González-Rivera M;Almansa R;Micheloud D;Tedim AP;Domínguez-Gil M;Resino S;Martín-Fernández M;Ryan Murua P;Pérez-García F;Tamayo L;Lopez-Izquierdo R;Bustamante E;Aldecoa C;Gómez JM;Rico-Feijoo J;Orduña A;Méndez R;Fernández Natal I;Megías G;González-Estecha M;Carriedo D;Doncel C;Jorge N;Ortega A;de la Fuente A;Del Campo F;Fernández-Ratero JA;Trapiello W;González-Jiménez P;Ruiz G;Kelvin AA;Ostadgavahi AT;Oneizat R;Ruiz LM;Miguéns I;Gargallo E;Muñoz I;Pelegrin S;Martín S;García Olivares P;Cedeño JA;Ruiz Albi T;Puertas C;Berezo JÁ;Renedo G;Herrán R;Bustamante-Munguira J;Enríquez P;Cicuendez R;Blanco J;Abadia J;Gómez Barquero J;Mamolar N;Blanca-López N;Valdivia LJ;Fernández Caso B;Mantecón MÁ;Motos A;Fernandez-Barat L;Ferrer R;Barbé F;Torres A;Menéndez R;Eiros JM;Kelvin DJ
通讯作者：
Kelvin DJ