Effect of adsorption column application on clinical and biochemical parameters in patients diagnosed with severe COVID-19 pneumonia

Aim: Effect of cytokine adsorption column application on clinical and biochemical parameters, and its relationship with death and short-term survival in patients diagnosed with severe Covid-19 pneumonia were evaluated. Materials and Methods: The study was carried out in Gaziantep University Şahinbey Research and Application Hospital Internal Medicine 16-bed Covid-19 Intensive Care Unit (ICU) between 01.04.2020 and 31.12.2020, over 18 years old, with a life expectancy above 48 hours, diagnosed with Covid-19 by PCR test positivity. Thirty patients with acute renal failure who were admitted to the intensive care unit due to severe Covid-19 pneumonia within 24 hours and who received continuous renal replacement therapy (CRRT) for this reason, who developed cytokine storm and who underwent cytokine adsorption column (Cytosorb®) application were included in the study. The conformity of the numerical variables to the normal distribution was tested with the Shaphiro Wilk test. SPSS 22.0 Windows version package program was used in the analysis. P< 0.05 was considered significant. Kaplan Meier method was used to estimate the lifespan. Results: The mean age of the patients in the study was 58 (19 -84). Twenty-three (76.3%) of the patients were male and 7 patients (23.7%) were female. The mean hospitalization day of the patients in the intensive care unit was calculated as 18.62 ± 11.56. The mean APACHE 2 score was 19.5 ± 7.52, and the SOFA score was 11.25 ± 3.15 on average. When the pH values of the patients were examined, a significant correlation was found between the measurements at the time of admission to the ICU and the measurements at the 24th hour of hospitalization (p=0.008). When the electrolytes were examined, a significant correlation was observed between the measurements of potassium, magnesium and phosphorus at the time of admission to the ICU and at the 24th hour of admission (p=0.008) (p=0.001) (p=0.014). When the kidney functions were examined, a significant correlation was found between the values of urea and creatinine measurements at the time of admission to the ICU and at the 24th hour of admission (p=0.010) (p=0.001). Conclusion: When the hemodynamic parameters (blood pressure, vasotropic inotrope score) of the patients in the study were compared within themselves, there was no significant difference between the levels of admission to the ICU and that of 24th hour. Acidosis and electrolyte imbalance improved after effective CRRT, and acute phase reactants regressed after removal of inflammatory cytokines from the body. Considering the hemogram parameters, leukocyte and thrombocyte levels improved secondary to antibiotic treatment and suppression of the inflammatory response. Keywords: Renal replacement therapy, COVID-19, Cytosorb®, pneumonia