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Effect of artificial liver blood purification treatment on the survival of critical ill COVID‐19 patients
Author(s) -
Dai Xiahong,
Zhang Yimin,
Yu Liang,
Jiang Yingan,
Chen Liang,
Chen Ye,
Li Ming,
Gao Chunming,
Shang Jia,
Xiang Shulin,
Li Yongguo,
Li Jianzhou,
Zhou Chenliang,
Zhou Xiaoyang,
Chen Nan,
Liu Yuanchun,
Liu Jing,
Zhang Yuanyuan,
Chen Xiaobei,
Zhu Danhua,
Gao Hainv,
Tang Lingling,
Zhu Mengfei,
Li Lanjuan
Publication year - 2021
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.13884
Subject(s) - medicine , pneumonia , gastroenterology , pneumonia severity index , cytokine storm , covid-19 , mortality rate , prospective cohort study , disease , community acquired pneumonia , infectious disease (medical specialty)
Our aim was to investigate the effect of artificial liver blood purification treatment on the survival of severe/critical patients with coronavirus disease 2019 (COVID‐19). A total of 101 severe and critical patients with coronavirus SARS‐CoV‐2 infection were enrolled in this open, case‐control, multicenter, prospective study. According to the patients’ and their families’ willingness, they were divided into two groups. One was named the treatment group, in which the patients received artificial liver therapy plus comprehensive treatment ( n = 50), while the other was named the control group, in which the patients received only comprehensive treatment ( n = 51). Clinical data and laboratory examinations, as well as the 28‐day mortality rate, were collected and analyzed. Baseline data comparisons on average age, sex, pre‐treatment morbidity, initial symptoms, vital signs, pneumonia severity index score, blood routine examination and biochemistry indices etc. showed no difference between the two groups. Cytokine storm was detected, with a significant increase of serum interleukin‐6 (IL‐6) level. The serum IL‐6 level decreased from 119.94 to 20.49 pg/mL in the treatment group and increased from 40.42 to 50.81 pg/mL in the control group ( P < .05), indicating that artificial liver therapy significantly decreased serum IL‐6. The median duration of viral nucleic acid persistence was 19 days in the treatment group (ranging from 6 to 67 days) and 17 days in the control group (ranging from 3 to 68 days), no significant difference was observed ( P = .36). As of 28‐day follow‐up,17 patients in the treatment group experienced a median weaning time of 24 days, while 11 patients in the control group experienced a median weaning time of 35 days, with no significant difference between the two groups ( P = .33). The 28‐day mortality rates were 16% (8/50) in the treatment group and 50.98% (26/51) in the control group, with a significant difference ( z = 3.70, P < .001). Cytokine storm is a key factor in the intensification of COVID‐19 pneumonia. The artificial liver therapy blocks the cytokine storm by clearing inflammatory mediators, thus preventing severe cases from progressing to critically ill stages and markedly reducing short‐term mortality.