Abstract: PO0160
COVID-19 vs. Bloodstream Purification: A Targeted Therapy
Session Information
- COVID-19: Vaccines, Diagnosis, and Treatment
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Author
- Barnett, Sean, Brooke Army Medical Center, Fort Sam Houston, Texas, United States
Background
The use of bloodstream purification has been well studied in bacteremia but the emergence of COVID found a new target. Using blood purification in the fight against COVID we have found a potential treatment for viremia and pneumonia, cytokine storm and decompensation, and superinfections in COVID. When used at the appropriate time, blood purification has the potential to prevent further organ injury.
Methods
The following case series is an individual clinical observation of patients withing the PURIFY NIH funded clinical trial.
Results
28M w/o significant PMHx, transferred to BAMC for ECMO due to severe COVID. He initially improved, but decompensated with MRSA bacteremia, was ECMO/CRRT and quadruple pressor dependent. He was treated with the Seraph for bloodstream purification and was off all vasopressors within 6 hours. He recovered, and was ultimately discharged without ECLS depdence.
64 M w/ CAD and CKD was admitted for mild COVID PNA requiring minimal o2. On hospital day 9-11 he decompensated ultimately requiring intubation and vasopressor support with AKI and oliguria. He was treated with the Seraph for 16 hours and was off vasopressors within 10 hours, urine output recovered within 24 hours, he was extubated in 48 hours and discharged from the ICU after 96 hours.
52 M w/ CKD/COPD/CHF/CAD admitted for mild COVID PNA, decompensated on day 12, required intubation / vasopressor support / CRRT, treated for 24 hours on CRRT with the Seraph Filter and was off vasopressors with returning renal function within 24 hours.
64 M w/ CKD/CHF/CAD admitted for NSTEMI and cardiogenic shock, found to be non-obstructive and likely viral cardiomyopathy due to COVID. He was started on dobutamine / levophed and IABP. Due to oliguria he was treated with CRRT and Seraph for blood purification. Within hours he was off vasopressors, no longer needing IABP after 24 hours, and ultimately recovered renal function within 48 hours.
Conclusion
While further study is needed, the use of blood purification for specific targets in COVID appears to have incredible benefits. Due to documented pathogen removal (bacteria/fungi/virions) it is likely beneficial treatment for any bloodstream infections, but especially in the susceptible COVID population it seems to have miraculous benefit. The Seraph also appears to mitigate organ injury from the cytokine storm in COVID due to attenuation of the cytokine storm.
Funding
- Other U.S. Government Support