Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases
Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new gene...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2021/5575928 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560163256532992 |
|---|---|
| author | José C. De La Flor Francisco Valga Alexander Marschall Tania Monzon Cristina Albarracín Elisa Ruiz Miguel Rodeles |
| author_facet | José C. De La Flor Francisco Valga Alexander Marschall Tania Monzon Cristina Albarracín Elisa Ruiz Miguel Rodeles |
| author_sort | José C. De La Flor |
| collection | DOAJ |
| description | Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (n = 3) were more likely to present bilateral pneumonia (100% vs 14.3%) at diagnosis and less reduction in interleukin 6 (IL-6) at day 14, as compared to those who survived. The use of the ATA membrane could be considered a therapeutic option, due to its immunomodulatory effect in MHD patients with SARS-CoV-2 infection, especially at the beginning of the disease, where the inflammatory component is predominant. |
| format | Article |
| id | doaj-art-1e91b6355da3410c93a9e52f56dc8c07 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-1e91b6355da3410c93a9e52f56dc8c072025-02-03T01:28:13ZengWileyCase Reports in Nephrology2090-66412090-665X2021-01-01202110.1155/2021/55759285575928Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 CasesJosé C. De La Flor0Francisco Valga1Alexander Marschall2Tania Monzon3Cristina Albarracín4Elisa Ruiz5Miguel Rodeles6Department of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, Doctor Negrín University Hospital, Las Palmas de Gran Canaria, SpainDepartment of Cardiology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Hemodialysis, Avericum S.L., Las Palmas de Gran Canaria, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainDepartment of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, SpainEarly reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (n = 3) were more likely to present bilateral pneumonia (100% vs 14.3%) at diagnosis and less reduction in interleukin 6 (IL-6) at day 14, as compared to those who survived. The use of the ATA membrane could be considered a therapeutic option, due to its immunomodulatory effect in MHD patients with SARS-CoV-2 infection, especially at the beginning of the disease, where the inflammatory component is predominant.http://dx.doi.org/10.1155/2021/5575928 |
| spellingShingle | José C. De La Flor Francisco Valga Alexander Marschall Tania Monzon Cristina Albarracín Elisa Ruiz Miguel Rodeles Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases Case Reports in Nephrology |
| title | Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases |
| title_full | Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases |
| title_fullStr | Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases |
| title_full_unstemmed | Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases |
| title_short | Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases |
| title_sort | targeting cytokine storm in covid 19 a role of online hemodiafiltration with asymmetric cellulose triacetate in maintenance hemodialysis patients a report of 10 cases |
| url | http://dx.doi.org/10.1155/2021/5575928 |
| work_keys_str_mv | AT josecdelaflor targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT franciscovalga targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT alexandermarschall targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT taniamonzon targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT cristinaalbarracin targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT elisaruiz targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases AT miguelrodeles targetingcytokinestormincovid19aroleofonlinehemodiafiltrationwithasymmetriccellulosetriacetateinmaintenancehemodialysispatientsareportof10cases |