COVID-19 Research Paper Volume 13, Issue 7 pp 9243—9252
The effectiveness of continuous renal replacement therapy in critical COVID-19 patients with cytokine release syndrome: a retrospective, multicenter, descriptive study from Wuhan, China
- 1 Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- 2 Department of Respiratory and Tuberculosis Disease, Wuhan Jinyintan Hospital, Wuhan, China
- 3 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Received: November 13, 2020 Accepted: January 22, 2021 Published: April 3, 2021https://doi.org/10.18632/aging.202838
How to Cite
Copyright: © 2021 Xiang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Coronavirus disease (COVID-19) has spread rapidly since 2019. Approximately 15% of the patients will develop severe complications such as multiple organ disease syndrome related to cytokine release syndrome (CRS). Continuous renal replacement therapy (CRRT) can remove inflammatory cytokines through filtration or adsorption. We evaluated the effectiveness of CRRT in COVID-19 patients with CRS.
Methods: This retrospective, multicenter, descriptive study included 83 patients with CRS from three hospitals in Wuhan.
Results: In COVID-19 patients with CRS, the fatality rate was even higher in CRRT group (P=0.005). However, inflammatory markers such as C-reactive protein, neutrophil counts, and D-dimer decreased after CRRT (P<0.05). Results of Lasso model showed that tracheotomy (β -1.31) and convalescent plasma (β -1.41) were the protective factors. In contrast, CRRT (β 1.07), respiratory failure (β 1.61), consolidation on lung CT (β 0.48), acute kidney injury (AKI) (β 0.47), and elevated neutrophil count (β 0.02) were the risk factors for death.
Conclusions: Our results showed that although CRRT significantly reduced the inflammation, it did not decrease the fatality rate of patients with CRS. Therefore, the choice of CRRT indication, dialysis time and dialysis mode should be more careful and accurate in COVID-19 patients with CRS.