Author: Caglayan M. Ayaz

Evaluation of Adsorption Therapy as an Extracorporeal Blood Purification Technique in Critically Ill Covid-19 Patients

We aimed to evaluate the efficacy of adsorption therapy as an extracorporeal blood purification technique in critically ill patients with Coronavirus disease 2019 (COVID-19). A retrospective analysis was performed on 17 adult patients with severe COVID-19, who underwent adsorption therapy using an HA330 cartridge, at Ankara City Hospital. Each adsorption therapy was administered for three consecutive days, and each therapy session lasted three hours. Several parameters, including cytokine levels, blood count, biochemistry panel, clinical status, and mortality rate were assessed before and after each therapy session. The results obtained from this study revealed that adsorption therapy reduced IL-6 levels and improved oxygenation in the short term. However, heart rate, mean arterial pressure and SOFA score did not demonstrate significant changes. Notably, the dose of norepinephrine increased after the third session. Regrettably, only 4 out of 17 patients (23.5%) survived. Consequently, adsorption therapy appears to be effective in reducing IL-6 levels in severe COVID-19 patients. Nonetheless, further investigation is warranted to evaluate its impact on clinical outcomes.

Does Intravenous Immunoglobulin Therapy Have a Role in the Treatment of Severe Coronavirus-19 Patients?

We wanted to evaluate the efficacy of intravenous immunoglobulin (IVIG) treatment in Covid-19 patients in the intensive care unit (ICU). Sixteen (66.7%) male and 8 (33.3%) female adult severe Covid-19 patients who were treated with IVIG in the tertiary ICU between April 2020 and October 2021 at Ankara City Hospital were retrospectively reviewed. The median age of the patients was 63 (interquartile range (IQR):19). The patients were evaluated in terms of laboratory values and clinical results before and after IVIG treatment. There was no statistically significant difference between survived and deceased Covid-19 patients treated with IVIG in terms of age, gender, the onset of symptoms, presence of concomitant diseases, APACHE-II scores, duration of mechanical ventilator support, and length of stay in the ICU. When the laboratory values before and after IVIG treatment were compared, a significant decrease was identified only in alanine transaminase levels (p=0.01). However, there was a statistically significant difference in mortality in 5 patients with Guillain-Barré syndrome who all survived (p=0.001). IVIG treatment was effective in Covid-19 patients with Guillain-Barré syndrome. However, IVIG treatment did not have a statistically significant effect on pre and post-treatment laboratory values, morbidity, and mortality of severe Covid-19 patients in the ICU.