Application of extracorporeal therapies in critically ill COVID-19 patients

• Published in: Journal of Zhejiang University. B. Science Vol. 22; no. 9; pp. 701 - 717
• Main Authors: Zhou, Zhifeng, Kuang, Huang, Ma, Yuexian, Zhang, Ling
• Format: Journal Article
• Language: English
• Published: Hangzhou Zhejiang University Press 01.09.2021; Springer Nature B.V; Department of Nephrology,Kidney Research Institute,West China Hospital,Sichuan University,Chengdu 610041,China%Renal Division,Peking University First Hospital,Peking University Institute of Nephrology,Key Laboratory of Renal Disease,Ministry of Health of China,Beijing 100034,China%Department of Nephrology,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China
• Subjects: Aerosols; Biomedical and Life Sciences; Biomedicine; Carbon dioxide; Carbon Dioxide - isolation & purification; Carbon dioxide removal; Coronaviruses; Corticoids; Corticosteroids; COVID-19; COVID-19 - complications; COVID-19 - therapy; Critical Illness; Cytokine Release Syndrome - therapy; Drug therapy; Extracorporeal Circulation - methods; Extracorporeal Membrane Oxygenation; Health services; Hemoperfusion; Humans; Immunization, Passive; Inhalation; Interferon; Mortality; Oxygenation; Pandemics; Patients; Plasma Exchange; Public health; Renal Replacement Therapy; Respiration; Respiratory diseases; Respiratory failure; Review; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Viral diseases; α-Interferon; 新型冠状病毒型肺炎(COVID-19); 细胞因子释放综合征(CRS); Critical illness; Acute kidney injury (AKI); Cytokine release syndrome (CRS); 急性肾损伤(AKI); Extracorporeal therapy; 体外疗法; 重症疾病; Coronavirus disease 2019 (COVID-19)
• ISSN: 1673-1581; 1862-1783
• DOI: 10.1631/jzus.B2100344

The coronavirus disease 2019 (COVID-19) pandemic is a major public health event caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread widely all over the world. A high proportion of patients become severely or critically ill, and suffer high mortality due to respiratory failure and multiple organ dysfunction. Therefore, providing timely and effective treatment for critically ill patients is essential to reduce overall mortality. Convalescent plasma therapy and pharmacological treatments, such as aerosol inhalation of interferon-α (IFN-α), corticosteroids, and tocilizumab, have all been applied in clinical practice; however, their effects remain controversial. Recent studies have shown that extracorporeal therapies might have a potential role in treating critically ill COVID-19 patients. In this review, we examine the application of continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), hemoadsorption (HA), extracorporeal membrane oxygenation (ECMO), and extracorporeal carbon dioxide removal (ECCO 2 R) in critically ill COVID-19 patients to provide support for the further diagnosis and treatment of COVID-19.