The early start of hemoperfusion decreases the mortality rate among severe COVID‐19 patients: A preliminary study

Abstract Background Coronavirus disease‐2019 (COVID‐19)‐related organ failure is partly related to a sepsis‐like syndrome and extreme pro‐inflammatory cytokine release, named cytokine storm. Therapeutic strategies that prevent the production of or remove the pro‐inflammatory cytokines could potentially be an effective therapy in critically afflicted COVID‐19 patients. Methods In this clinical trial study, from April until June 2020, 68 COVID‐19 patients (35 vs. 33 controls) with severe critical symptoms, and PaO 2 /FiO 2 (P/F) ratio less than 200 mmHg either received a single standard therapy or a combination of standard treatment for COVID‐19 combined with hemoperfusion (hemofilter, HA330 D Javfron) for 4 h, in 3 consecutive days. The length of hospital stay and mechanical ventilation, the resolution of radiologic abnormalities, and the mortality rate were defined as the primary outcomes. Results Demographic characteristics, the acute physiology, and chronic health evaluation score of both groups were similar ( p > 0.05). Importantly, we noticed a significant mortality rate reduction in the perfused group compared with controls (37.1% vs. 63.6%, p = 0.02), this positive effect was stronger among those with a P/F ratio higher than 75 (mortality rate of 84.7% for P/F ratio < 75 vs. 15.4% for P/F ratio ≥ 75, p = 0.02). Conclusions The results imply that early start of hemoperfusion could be more effective and significantly reduce the mortality rate among COVID‐19 patients with critical diseases.