Successful Management of Critical Acute Respiratory Distress Syndrome following COVID-19 through Extracorporeal Membrane Oxygenation in a Patient with Concurrent Nephrotic Syndrome Relapse
A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorpor...
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| Published in | Internal Medicine Vol. 62; no. 21; pp. 3209 - 3214 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Japan
The Japanese Society of Internal Medicine
01.11.2023
Japan Science and Technology Agency |
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| Abstract | A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases. |
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| AbstractList | A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases. A 44-year-old man with COVID-19 and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases. A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases.A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases. |
| ArticleNumber | 2293-23 |
| Author | Nomura, Tomohisa Hosoya, Reina Io, Hiroaki Fukao, Yusuke Suzuki, Yusuke Muto, Masahiro Sasaki, Yu Kano, Toshiki Sugita, Manabu |
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| Cites_doi | 10.1016/j.antiviral.2019.104620 10.1038/nrneph.2012.41 10.1186/s12879-021-06536-3 10.1136/annrheumdis-2020-218310 10.1016/j.kint.2020.10.032 10.1128/AAC.01168-20 10.1016/S2213-2600(20)30079-5 10.1016/S2213-2600(22)00296-X 10.1177/2040622321998860 10.1186/s13054-021-03634-1 10.3389/fimmu.2021.677957 10.1007/s40620-021-01206-8 10.1007/s00467-022-05702-2 10.1016/j.jinf.2020.04.021 10.1016/j.eclinm.2020.100591 10.1016/j.ccc.2022.01.002 10.1016/j.virusres.2012.02.002 10.1136/bmj.m1985 10.1001/jamainternmed.2020.0994 10.1016/j.ekir.2021.08.009 10.1186/s13054-022-04187-7 |
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| Keywords | nephrotic syndrome relapse chronic kidney disease extracorporeal membrane oxygenation coronavirus disease 2019 |
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| Notes | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Report-1 ObjectType-Feature-4 content type line 23 ObjectType-Article-3 Correspondence to Dr. Hiroaki Io, hiroaki@juntendo.ac.jp |
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| References | 16. Fernández-Cruz A, Ruiz-Antorán B, Muñoz-Gómez A, et al. A retrospective controlled cohort study of the impact of glucocorticoid treatment in SARS-CoV-2 infection mortality. Antimicrob Agents Chemother 64: e01168-20, 2020. 17. Sterne JAC, Murthy S, Diaz JV, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA 324: 1330-1341, 2020. 1. Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis 21: 855, 2021. 7. Tran A, Fernando SM, Rochwerg B, et al. Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Lancet Respir Med 11: 235-244, 2023. 4. Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 180: 934-943, 2020. 5. Ohshimo S, Liu K, Ogura T, et al. Trends in survival during the pandemic in patients with critical COVID-19 receiving mechanical ventilation with or without ECMO: analysis of the Japanese national registry data. Crit Care 26: 354, 2022. 13. Hilton J, Boyer N, Nadim MK, Forni LG, Kellum JA. COVID-19 and acute kidney injury. Crit Care Clin 38: 473-489, 2022. 11. Heine GH, Ortiz A, Massy ZA, et al. Monocyte subpopulations and cardiovascular risk in chronic kidney disease. Nat Rev Nephrol 8: 362-369, 2012. 3. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 369: m1985, 2020. 15. Salas A, Kant S, Floyd L, et al. ANCA vasculitis induction management during the COVID-19 pandemic. Kidney Int Rep 6: 2903-2907, 2021. 20. Guisado-Vasco P, Valderas-Ortega S, Carralón-González MM, et al. Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: a retrospective observational study (COQUIMA cohort). EClinicalMedicine 28: 100591, 2020. 10. Lin YC, Lai TS, Lin SL, Chen YM, Chu TS, Tu YK. Outcomes of coronavirus 2019 infection in patients with chronic kidney disease: a systematic review and meta-analysis. Ther Adv Chronic Dis 12: 2040622321998860, 2021. 9. Zhang M, Bai X, Cao W, et al. The influence of corticosteroids, immunosuppressants and biologics on patients with inflammatory bowel diseases, psoriasis and rheumatic diseases in the era of COVID-19: a review of current evidence. Front Immunol 12: 677957, 2021. 8. Jdiaa SS, Mansour R, El Alayli A, Gautam A, Thomas P, Mustafa RA. COVID-19 and chronic kidney disease: an updated overview of reviews. J Nephrol 35: 69-85, 2022. 22. Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: a systematic literature review and meta-analysis. J Infect 81: e16-e25, 2020. 6. Ramanathan K, Shekar K, Ling RR, et al. Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Crit Care 25: 211, 2021. 12. Waldman M, Soler MJ, García-Carro C, et al. Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring. Kidney Int 99: 227-237, 2021. 18. Carbajo-Lozoya J, Müller MA, Kallies S, Thiel V, Drosten C, von Brunn A. Replication of human coronaviruses SARS-CoV, HCoV-NL63 and HCoV-229E is inhibited by the drug FK506. Virus Res 165: 112-117, 2012. 19. Ma-Lauer Y, Zheng Y, Malešević M, von Brunn B, Fischer G, von Brunn A. Influences of cyclosporin A and non-immunosuppressive derivatives on cellular cyclophilins and viral nucleocapsid protein during human coronavirus 229E replication. Antiviral Res 173: 104620, 2020. 21. Chiodini B, Bellotti AS, Morello W, et al. Relapse rate in children with nephrotic syndrome during the SARS-CoV-2 pandemic. Pediatr Nephrol 38: 1139-1146, 2023. 2. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 8: 475-481, 2020. 14. FAI2R/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE Consortium and Contributors. Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients. Ann Rheum Dis 80: 527-538, 2021. 11 22 12 13 14 15 16 17 18 19 1 2 3 4 5 6 7 8 9 20 10 21 |
| References_xml | – reference: 17. Sterne JAC, Murthy S, Diaz JV, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA 324: 1330-1341, 2020. – reference: 3. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 369: m1985, 2020. – reference: 22. Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: a systematic literature review and meta-analysis. J Infect 81: e16-e25, 2020. – reference: 1. Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis 21: 855, 2021. – reference: 8. Jdiaa SS, Mansour R, El Alayli A, Gautam A, Thomas P, Mustafa RA. COVID-19 and chronic kidney disease: an updated overview of reviews. J Nephrol 35: 69-85, 2022. – reference: 5. Ohshimo S, Liu K, Ogura T, et al. Trends in survival during the pandemic in patients with critical COVID-19 receiving mechanical ventilation with or without ECMO: analysis of the Japanese national registry data. Crit Care 26: 354, 2022. – reference: 13. Hilton J, Boyer N, Nadim MK, Forni LG, Kellum JA. COVID-19 and acute kidney injury. Crit Care Clin 38: 473-489, 2022. – reference: 15. Salas A, Kant S, Floyd L, et al. ANCA vasculitis induction management during the COVID-19 pandemic. Kidney Int Rep 6: 2903-2907, 2021. – reference: 18. Carbajo-Lozoya J, Müller MA, Kallies S, Thiel V, Drosten C, von Brunn A. Replication of human coronaviruses SARS-CoV, HCoV-NL63 and HCoV-229E is inhibited by the drug FK506. Virus Res 165: 112-117, 2012. – reference: 6. Ramanathan K, Shekar K, Ling RR, et al. Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Crit Care 25: 211, 2021. – reference: 2. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 8: 475-481, 2020. – reference: 16. Fernández-Cruz A, Ruiz-Antorán B, Muñoz-Gómez A, et al. A retrospective controlled cohort study of the impact of glucocorticoid treatment in SARS-CoV-2 infection mortality. Antimicrob Agents Chemother 64: e01168-20, 2020. – reference: 20. Guisado-Vasco P, Valderas-Ortega S, Carralón-González MM, et al. Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: a retrospective observational study (COQUIMA cohort). EClinicalMedicine 28: 100591, 2020. – reference: 9. Zhang M, Bai X, Cao W, et al. The influence of corticosteroids, immunosuppressants and biologics on patients with inflammatory bowel diseases, psoriasis and rheumatic diseases in the era of COVID-19: a review of current evidence. Front Immunol 12: 677957, 2021. – reference: 4. Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 180: 934-943, 2020. – reference: 10. Lin YC, Lai TS, Lin SL, Chen YM, Chu TS, Tu YK. Outcomes of coronavirus 2019 infection in patients with chronic kidney disease: a systematic review and meta-analysis. Ther Adv Chronic Dis 12: 2040622321998860, 2021. – reference: 7. Tran A, Fernando SM, Rochwerg B, et al. Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Lancet Respir Med 11: 235-244, 2023. – reference: 14. FAI2R/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE Consortium and Contributors. Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients. Ann Rheum Dis 80: 527-538, 2021. – reference: 19. Ma-Lauer Y, Zheng Y, Malešević M, von Brunn B, Fischer G, von Brunn A. Influences of cyclosporin A and non-immunosuppressive derivatives on cellular cyclophilins and viral nucleocapsid protein during human coronavirus 229E replication. Antiviral Res 173: 104620, 2020. – reference: 11. Heine GH, Ortiz A, Massy ZA, et al. Monocyte subpopulations and cardiovascular risk in chronic kidney disease. Nat Rev Nephrol 8: 362-369, 2012. – reference: 12. Waldman M, Soler MJ, García-Carro C, et al. Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring. Kidney Int 99: 227-237, 2021. – reference: 21. Chiodini B, Bellotti AS, Morello W, et al. Relapse rate in children with nephrotic syndrome during the SARS-CoV-2 pandemic. Pediatr Nephrol 38: 1139-1146, 2023. – ident: 17 – ident: 19 doi: 10.1016/j.antiviral.2019.104620 – ident: 11 doi: 10.1038/nrneph.2012.41 – ident: 1 doi: 10.1186/s12879-021-06536-3 – ident: 14 doi: 10.1136/annrheumdis-2020-218310 – ident: 12 doi: 10.1016/j.kint.2020.10.032 – ident: 16 doi: 10.1128/AAC.01168-20 – ident: 2 doi: 10.1016/S2213-2600(20)30079-5 – ident: 7 doi: 10.1016/S2213-2600(22)00296-X – ident: 10 doi: 10.1177/2040622321998860 – ident: 6 doi: 10.1186/s13054-021-03634-1 – ident: 9 doi: 10.3389/fimmu.2021.677957 – ident: 8 doi: 10.1007/s40620-021-01206-8 – ident: 21 doi: 10.1007/s00467-022-05702-2 – ident: 22 doi: 10.1016/j.jinf.2020.04.021 – ident: 20 doi: 10.1016/j.eclinm.2020.100591 – ident: 13 doi: 10.1016/j.ccc.2022.01.002 – ident: 18 doi: 10.1016/j.virusres.2012.02.002 – ident: 3 doi: 10.1136/bmj.m1985 – ident: 4 doi: 10.1001/jamainternmed.2020.0994 – ident: 15 doi: 10.1016/j.ekir.2021.08.009 – ident: 5 doi: 10.1186/s13054-022-04187-7 |
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| Snippet | A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure.... A 44-year-old man with COVID-19 and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical... |
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| SubjectTerms | Case Report chronic kidney disease coronavirus disease 2019 Coronaviruses COVID-19 extracorporeal membrane oxygenation Hemodialysis Hypoxemia Immunomodulation Internal medicine Mechanical ventilation Nephrotic syndrome nephrotic syndrome relapse Oxygenation Proteinuria Renal function Respiratory distress syndrome |
| Title | Successful Management of Critical Acute Respiratory Distress Syndrome following COVID-19 through Extracorporeal Membrane Oxygenation in a Patient with Concurrent Nephrotic Syndrome Relapse |
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