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Abstract: PO0162

Direct Hemoperfusion Using a Polymyxin B-Immobilized Polystyrene Column for COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Katagiri, Daisuke, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
  • Suzuki, Minami, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
  • Sakamoto, Emi, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
  • Niikura, Takahito, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
  • Noiri, Eisei, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
  • Takano, Hideki, National Center for Global Health and Medicine, Department of Nephrology, Tokyo, Tokyo, Japan
Background

The involvement of increased cytokine levels in severe COVID-19 has been noted, and anti-inflammatory therapy including corticosteroids or anti-human interleukin (IL)-6 receptor monoclonal antibody is expected to be effective in such patients. Direct hemoperfusion using a polymyxin B-immobilized polystyrene column (PMX) is a treatment that selectively adsorbs endotoxins; it is also expected to adsorb a variety of endogenous substances.

Methods

The patients (N=22) included were those whose respiratory samples tested positive for SARS-CoV-2 upon real-time reverse transcription-polymerase chain reaction (RT-PCR) and underwent PMX during hospitalization at National Center for Global Health and Medicine, Tokyo, Japan between January 30 2020 and April 30, 2021. PMX was considered when an image of pneumonia consistent with COVID-19 was obtained on chest CT and the P/F ratio was less than 300. Demographic data, information on clinical symptoms, and laboratory data were collected.

Results

On day 15 of first PMX treatment, disease severity decreased in 63.6 % of the patients. P/F ratio increased and there was a downward trend in urine β2-microglobulin on days 4 and 8. Cytokine level measurement pre- and post-PMX revealed a downward trend in interleukin-6 levels and decreased levels of the factors involved in vascular endothelial injury, including vascular endothelial growth factor. There were 43 PMX, of which nine and five caused an increase in inlet pressure and membrane coagulation, respectively. When the membranes coagulated, the circuitry needed to be reconfigured.

Conclusion

PMX is expected to become a therapy to address medical needs and prevent the exacerbation from moderate to severe condition in COVID-19.