nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2021-25-4-95-106nefr-2015Research ArticleПРОГРАММА НЕПРЕРЫВНОГО ПОСЛЕДИПЛОМНОГО ОБРАЗОВАНИЯ ПО НЕФРОЛОГИИPROGRAM ON CONTINUOUS POSTGRADUATE EDUCATION ON NEPHROLOGYЭкстракорпоральные методы гемокоррекции при COVID-19: есть ли перспективы?Extracorporal hemocorrection methods for COVID-19: are there outlooks?https://orcid.org/0000-0002-9455-1043РумянцевА. Ш.RumyantsevA. Sh.

Проф. Румянцев Александр Шаликович, д-р мед. наук, кафедра факультетской терапии; кафедра пропедевтики внутренних болезней

199106, Санкт-Петербург, 21-я линия В.О., д. 8а, тел.: +7 (812) 326-03-26

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8, тел.: +7(911)2677413

Prof. Rumyantsev Aleksandr Shalikovich, MD, PhD, DMedSci, department of faculty therapy; Department of Propaedeutics of Internal Medicine

199106, St. Petersburg, 21st line V.O., 8a, phone:+7 (812)326-03-26

197022, Saint Petersburg, L'va Tolstogo str. 6-8, phone: +7 (911) 2677413

 

rash.56@mail.ruhttps://orcid.org/0000-0002-5722-8693ХасунМ. Х.KhasunM. Kh.

Доц. Хасун Мохамад, канд. мед. наук, кафедра пропедевтики внутренних болезней

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54

Тел.: (812) 346-39-26

Associate Prof. Khasun Mohamad, MD, PhD, Department of Propudeutics of Internal Diseases

197022, St-Petersburg, L. Tolstoy st., 17, build. 54 

Phone: (812)346-39-26

nefrolog2013@mail.ruhttps://orcid.org/0000-0002-0586-468XПанинаИ. Ю.PaninaI. Yu.

Проф. Панина Ирина Юрьевна, д-р мед. наук, кафедра пропедевтики внутренних болезней

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8.

Тел.: (812) 906-97-53

Prof. Irina Yu. Panina, MD, PhD, DMedSci, Department of Propaedeutics of Internal Medicine

197022, Saint Petersburg, L'va Tolstogo str. 6-8

Phone: (812) 906-97-53

i.u.panina@mail.ruhttps://orcid.org/0000-0002-9455-1043КоростелеваН. Ю.KorostelevaN. Yu.

Коростелева Наталья Юрьевна, канд. мед. наук, НИИ нефрологии, старший научный сотрудник

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

Тел.: +7(911)9184549

Natalya Yu. Korosteleva, MD, PhD, Research Institute of Nephrology, senior researcher

197022, Saint Petersburg, L'va Tolstogo str. 6-8

Phone: +7 (911) 9184549

natkor_spb@mail.ruhttps://orcid.org/0000-0002-6030-8141ШураковаВ. А.ShurakovaV. A.

Шуракова Вера Андреевна, кафедра пропедевтики внутренних болезней

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

Тел.: (812) 906-97-53

Vera A. Shurakova, MD, Department of Propaedeutics of Internal Medicine

197022, Saint Petersburg, L'va Tolstogo, str. 6-8

Phone: (812) 906-97-53

v.a.shurakova95@gmail.comhttps://orcid.org/0000-0002-4219-1461ЗемченковГ. А.ZemchenkovG. A.

Земченков Геннадий Александрович

193318, Санкт-Петербург, ул. Бадаева, д. 1, стр. 1.

Тел.: +7(812) 334-76-30

Gennadiy A. Zemchenkov, MD

Phone: +7(812) 334-76-30

zga13@yandex.ruСанкт-Петербургский государственный университет; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияSaint Petersburg State University; First Saint Petersburg State Medical University named after Academician I.P. PavlovRussian FederationПервый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияFirst Saint Petersburg State Medical University named after Academician I.P. PavlovRussian FederationББраун Авиум Руссланд КлиниксРоссияBBraun Avitum Russland ClinicsRussian Federation20211607202125495106Copyright © Румянцев А.Ш., Хасун М.Х., Панина И.Ю., Коростелева Н.Ю., Шуракова В.А., Земченков Г.А., 20212021Румянцев А.Ш., Хасун М.Х., Панина И.Ю., Коростелева Н.Ю., Шуракова В.А., Земченков Г.А.Rumyantsev A.S., Khasun M.K., Panina I.Y., Korosteleva N.Y., Shurakova V.A., Zemchenkov G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2015

Вирусные эпидемии, различные по своим масштабам, перестали быть чем-то экстраординарным. Однако вряд ли с эпидемией COVID-19 может сравниться какая-либо другая, кроме эпидемии «испанки» 1918–1919 гг. В обзоре обсуждаются вопросы патогенеза «цитокинового шторма» и возможных экстракорпоральных методов его коррекции. В соответствии с «Третьим международным консенсусом по определению сепсиса и септического шока (Сепсис-3)» под сепсисом рекомендуют понимать «жизнеугрожающую острую органную дисфункцию, возникающую в результате нарушения регуляции ответа макроорганизма на инфекцию». Тяжелое течение COVID-19 практически является вариантом вирусного сепсиса. Однако заболевание не кодируют как сепсис и не относятся к нему как к сепсису. Большие надежды возлагают на вакцинацию, которая, предположительно, должна существенно снизить вероятность неблагоприятных исходов. Однако пока эпидемиологическая ситуация далека от идеала, «золотые» стандарты лекарственной терапии отсутствуют. Поэтому не стоит забывать о прямых методах удаления провоспалительных цитокинов. Среди них обсуждаются гемофильтрация, комбинированная гемокоррекция, плазмаобмен, сочетанная плазмафильтрация и адсорбция. Нам не удалось выделить идеальный метод. Вероятно, это связано с трудностями проведения рандомизированных клинических исследований среди пациентов с тяжелым течением COVID-19. Причины также обсуждаются в обзоре.

Viral epidemics of various scales have ceased to be something extraordinary. However, it is unlikely that the COVID-19 epidemic can be compared to any other, except the Spanish flu epidemic of 1918-1919. The review discusses the pathogenesis of the "cytokine storm" and possible extracorporeal methods of its correction. Following the "Third International Consensus on the definition of sepsis and septic shock (Sepsis-3)", sepsis is recommended to be understood as "life-threatening acute organ dysfunction resulting from a violation of the regulation of the response of the macroorganism to infection". Severe COVID-19 is practically a variant of viral sepsis. However, the disease is not coded as sepsis and is not treated as sepsis. Great hopes are pinned on vaccination, which, presumably, should significantly reduce the likelihood of adverse outcomes. However, while the epidemiological situation is far from ideal, there are no "golden" standards of drug therapy. Therefore, do not forget about direct methods of removing proinflammatory cytokines. Among them, hemofiltration, combined hemocorrection, plasma exchange, combined plasma filtration, and adsorption are discussed. We were not able to identify the ideal method. This is probably due to the difficulties of performing randomized clinical trials among patients with severe COVID-19. The reasons are also discussed in the review.

сепсис«цитокиновый шторм»COVID-19экстракорпоральная гемокоррецияsepsis"cytokine storm"COVID-19extracorporeal hemocorrectionReferencesOsler W. The study of the fevers of the South. JAMA 1896; XXVI (21):999–1004. doi:10.1001/jama.1896.02430730001001Osler W. The study of the fevers of the South. JAMA 1896; XXVI (21):999–1004. doi:10.1001/jama.1896.02430730001001Frost WH Statistics of influenza morbidity. Public Health Rep 1920;35:584–597 10.2307/4575511Frost WH Statistics of influenza morbidity. Public Health Rep 1920;35:584–597 10.2307/4575511Taubenberger JK, Morens DM. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis 2006 Jan;12(1):15–22. doi: 10.3201/eid1201.050979Taubenberger JK, Morens DM. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis 2006 Jan;12(1):15–22. doi: 10.3201/eid1201.050979Arvin A, Campadelli-Fiume G, Mocarski E, Moore PS, Roizman B, Whitley R, Yamanishi K, editors. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge: Cambridge University Press; 2007Arvin A, Campadelli-Fiume G, Mocarski E, Moore PS, Roizman B, Whitley R, Yamanishi K, editors. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge: Cambridge University Press; 2007James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL, Looker KJ. Herpes simplex virus: global infection prevalence and incidence estimates, 2016. Bull World Health Organ 2020 May 1;98(5):315–329. doi: 10.2471/BLT.19.237149James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL, Looker KJ. Herpes simplex virus: global infection prevalence and incidence estimates, 2016. Bull World Health Organ 2020 May 1;98(5):315–329. doi: 10.2471/BLT.19.237149WHO. Global hepatitis report, 2017. https://www.who.int/hepatitis/publications/global-hepatitis-report2017/enWHO. Global hepatitis report, 2017. https://www.who.int/hepatitis/publications/global-hepatitis-report2017/enWHO. Hepatitis C fact sheet. 2017; http://www.who.int/news-room/fact-sheets/detail/hepatitis-cWHO. Hepatitis C fact sheet. 2017; http://www.who.int/news-room/fact-sheets/detail/hepatitis-chttps://www.worldometers.info/coronavirushttps://www.worldometers.info/coronavirusЧеркасский БЛ. Инфекционные и паразитарные болезни человека. Справочн. эпидемиолога. Медицинская газета, М., 1994: 617Черкасский БЛ. Инфекционные и паразитарные болезни человека. Справочн. эпидемиолога. Медицинская газета, М., 1994: 617Шандала М.Г. Актуальные проблемы сочетанного применения прививочных и неиммунологических методов борьбы с инфекциями. Вестник Российской академии медицинских наук 2012;67(10):49–54Шандала М.Г. Актуальные проблемы сочетанного применения прививочных и неиммунологических методов борьбы с инфекциями. Вестник Российской академии медицинских наук 2012;67(10):49–54https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.htmlhttps://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.htmlJiang S, Hillyer C, Du L. Neutralizing Antibodies against SARS-CoV-2 and Other Human Coronaviruses. Trends Immunol 2020 May;41(5):355–359. doi: 10.1016/j.it.2020.03.007Jiang S, Hillyer C, Du L. Neutralizing Antibodies against SARS-CoV-2 and Other Human Coronaviruses. Trends Immunol 2020 May;41(5):355–359. doi: 10.1016/j.it.2020.03.007Wang P, Nair MS, Liu L et al. Increased Resistance of SARS-CoV-2 Variants B.1.351 and B.1.1.7 to Antibody Neutralization. bioRxiv [Preprint]. 2021 Jan 26:2021.01.25.428137. doi: 10.1101/2021.01.25.428137Wang P, Nair MS, Liu L et al. Increased Resistance of SARS-CoV-2 Variants B.1.351 and B.1.1.7 to Antibody Neutralization. bioRxiv [Preprint]. 2021 Jan 26:2021.01.25.428137. doi: 10.1101/2021.01.25.428137Wang Y, Zhang L, Sang L et al. Kinetics of viral load and antibody response in relation to COVID-19 severity. J Clin Invest 2020 Oct 1;130(10):5235–5244. doi: 10.1172/JCI138759Wang Y, Zhang L, Sang L et al. Kinetics of viral load and antibody response in relation to COVID-19 severity. J Clin Invest 2020 Oct 1;130(10):5235–5244. doi: 10.1172/JCI138759Weinreich DM, Sivapalasingam S, Norton T et al. REGNCOV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19. N Engl J Med 2021 Jan 21;384(3):238–251. doi: 10.1056/NEJMoa2035002Weinreich DM, Sivapalasingam S, Norton T et al. REGNCOV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19. N Engl J Med 2021 Jan 21;384(3):238–251. doi: 10.1056/NEJMoa2035002Giuseppe Gritti, Federico Raimondi, Diego Ripamonti et al. Use of siltuximab in patients with COVID-19 pneumonia requiring ventilatory support. medRxiv 2020.04.01.20048561; doi: https://doi.org/10.1101/2020.04.01.20048561Giuseppe Gritti, Federico Raimondi, Diego Ripamonti et al. Use of siltuximab in patients with COVID-19 pneumonia requiring ventilatory support. medRxiv 2020.04.01.20048561; doi: https://doi.org/10.1101/2020.04.01.20048561Gupta S, Wang W, Hayek SS et al. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. JAMA Intern Med 2021 Jan 1;181(1):41– 51. doi: 10.1001/jamainternmed.2020.6252Gupta S, Wang W, Hayek SS et al. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. JAMA Intern Med 2021 Jan 1;181(1):41– 51. doi: 10.1001/jamainternmed.2020.6252Hermine O, Mariette X, Tharaux PL STOP-COVID Investigators. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia: A Randomized Clinical Trial. JAMA Intern Med 2021 Jan 1;181(1):32–40. doi: 10.1001/jamainternmed.2020.6820Hermine O, Mariette X, Tharaux PL STOP-COVID Investigators. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia: A Randomized Clinical Trial. JAMA Intern Med 2021 Jan 1;181(1):32–40. doi: 10.1001/jamainternmed.2020.6820Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5Lier AJ, Tuan JJ, Davis MW et al. Case Report: Disseminated Strongyloidiasis in a Patient with COVID-19. Am J Trop Med Hyg 2020 Oct;103(4):1590–1592. doi: 10.4269/ajtmh.20-0699Lier AJ, Tuan JJ, Davis MW et al. Case Report: Disseminated Strongyloidiasis in a Patient with COVID-19. Am J Trop Med Hyg 2020 Oct;103(4):1590–1592. doi: 10.4269/ajtmh.20-0699REMAP-CAP Investigators, Gordon AC, Mouncey PR et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med 2021 Apr 22;384(16):1491–1502. doi: 10.1056/NEJMoa2100433REMAP-CAP Investigators, Gordon AC, Mouncey PR et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med 2021 Apr 22;384(16):1491–1502. doi: 10.1056/NEJMoa2100433Salama C, Han J, Yau L et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med 2021 Jan 7;384(1):20–30. doi: 10.1056/NEJMoa2030340Salama C, Han J, Yau L et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med 2021 Jan 7;384(1):20–30. doi: 10.1056/NEJMoa2030340Lescure FX, Honda H, Fowler RA et al. Sarilumab in patients admitted to hospital with severe or critical COVID-19: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med 2021 May;9(5):522–532. doi: 10.1016/S2213-2600(21)00099-0Lescure FX, Honda H, Fowler RA et al. Sarilumab in patients admitted to hospital with severe or critical COVID-19: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med 2021 May;9(5):522–532. doi: 10.1016/S2213-2600(21)00099-0Stone JH, Frigault MJ, Serling-Boyd NJ et al. Efficacy of Tocilizumab in Patients Hospitalized with Covid-19. N Engl J Med 2020 Dec 10;383(24):2333–2344. doi: 10.1056/NEJMoa2028836Stone JH, Frigault MJ, Serling-Boyd NJ et al. Efficacy of Tocilizumab in Patients Hospitalized with Covid-19. N Engl J Med 2020 Dec 10;383(24):2333–2344. doi: 10.1056/NEJMoa2028836Agarwal A, Mukherjee A, Kumar G et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial) BMJ 2020; 371 :m3939 doi:10.1136/bmj.m3939Agarwal A, Mukherjee A, Kumar G et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial) BMJ 2020; 371 :m3939 doi:10.1136/bmj.m3939AlQahtani M, Abdulkarim A, Almadani A et al. Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease. medRxiv 2020.11.02.20224303; doi: https://doi.org/10.1101/2020.11.02.20224303AlQahtani M, Abdulkarim A, Almadani A et al. Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease. medRxiv 2020.11.02.20224303; doi: https://doi.org/10.1101/2020.11.02.20224303Avendano-Sola C, Ramos-Martinez A, Muñez-Rubio E et al. Convalescent plasma for COVID-19: a multicenter, randomized clinical trial. Convalescent Plasma for COVID-19: A multicenter, randomized clinical trial. medRxiv 2020.08.26.20182444; doi: https://doi.org/10.1101/2020.08.26.20182444Avendano-Sola C, Ramos-Martinez A, Muñez-Rubio E et al. Convalescent plasma for COVID-19: a multicenter, randomized clinical trial. Convalescent Plasma for COVID-19: A multicenter, randomized clinical trial. medRxiv 2020.08.26.20182444; doi: https://doi.org/10.1101/2020.08.26.20182444Choi B, Choudhary MC, Regan J et al. Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host. N Engl J Med 2020 Dec 3;383(23):2291–2293. doi: 10.1056/NEJMc2031364Choi B, Choudhary MC, Regan J et al. Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host. N Engl J Med 2020 Dec 3;383(23):2291–2293. doi: 10.1056/NEJMc2031364Clark E, Guilpain P, Filip IL et al. Convalescent plasma for persisting COVID-19 following therapeutic lymphocyte depletion: a report of rapid recovery. Br J Haematol 2020 Aug;190(3):e154– e156. doi: 10.1111/bjh.16981Clark E, Guilpain P, Filip IL et al. Convalescent plasma for persisting COVID-19 following therapeutic lymphocyte depletion: a report of rapid recovery. Br J Haematol 2020 Aug;190(3):e154– e156. doi: 10.1111/bjh.16981Fung M, Nambiar A, Pandey S et al. Treatment of immunocompromised COVID-19 patients with convalescent plasma. Transpl Infect Dis 2021 Apr;23(2):e13477. doi: 10.1111/tid.13477Fung M, Nambiar A, Pandey S et al. Treatment of immunocompromised COVID-19 patients with convalescent plasma. Transpl Infect Dis 2021 Apr;23(2):e13477. doi: 10.1111/tid.13477Gharbharan A, Jordans CCE, Geurtsvankessel C et al. Convalescent Plasma for COVID-19. A randomized clinical trial. medRxiv 2020.07.01.20139857; doi: https://doi.org/10.1101/2020.07.01.20139857Gharbharan A, Jordans CCE, Geurtsvankessel C et al. Convalescent Plasma for COVID-19. A randomized clinical trial. medRxiv 2020.07.01.20139857; doi: https://doi.org/10.1101/2020.07.01.20139857Hueso T, Pouderoux C, Pere H et al. Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19. Blood 2020 Nov 12;136(20):2290–2295. doi: 10.1182/blood.2020008423Hueso T, Pouderoux C, Pere H et al. Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19. Blood 2020 Nov 12;136(20):2290–2295. doi: 10.1182/blood.2020008423Iaboni A, Wong N, Betschel SD A Patient with X-Linked Agammaglobulinemia and COVID-19 Infection Treated with Remdesivir and Convalescent Plasma. J Clin Immunol 2021 Feb 6:1–3. doi: 10.1007/s10875-021-00983-y. Epub ahead of printIaboni A, Wong N, Betschel SD A Patient with X-Linked Agammaglobulinemia and COVID-19 Infection Treated with Remdesivir and Convalescent Plasma. J Clin Immunol 2021 Feb 6:1–3. doi: 10.1007/s10875-021-00983-y. Epub ahead of printJoyner MJ, Carter RE, Senefeld JW et al. Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19. N Engl J Med 2021 Mar 18;384(11):1015–1027. doi: 10.1056/NEJMoa2031893Joyner MJ, Carter RE, Senefeld JW et al. Convalescent Plasma Antibody Levels and the Risk of Death from Covid-19. N Engl J Med 2021 Mar 18;384(11):1015–1027. doi: 10.1056/NEJMoa2031893Kemp SA, Collier DA, Datir RP et al. SARS-CoV-2 evolution during treatment of chronic infection. Nature 2021 Apr;592(7853):277–282. doi: 10.1038/s41586-021-03291-yKemp SA, Collier DA, Datir RP et al. SARS-CoV-2 evolution during treatment of chronic infection. Nature 2021 Apr;592(7853):277–282. doi: 10.1038/s41586-021-03291-yLi L, Zhang W, Hu Y et al. Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. JAMA 2020 Aug 4;324(5):460–470. doi: 10.1001/jama.2020.10044Li L, Zhang W, Hu Y et al. Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. JAMA 2020 Aug 4;324(5):460–470. doi: 10.1001/jama.2020.10044Libster R, Pérez Marc G, Wappner D et al. Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. N Engl J Med 2021 Feb 18;384(7):610–618. doi: 10.1056/NEJMoa2033700Libster R, Pérez Marc G, Wappner D et al. Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. N Engl J Med 2021 Feb 18;384(7):610–618. doi: 10.1056/NEJMoa2033700Mira E, Yarce OA, Ortega C et al. Rapid recovery of a SARS-CoV-2-infected X-linked agammaglobulinemia patient after infusion of COVID-19 convalescent plasma. J Allergy Clin Immunol Pract 2020 Sep;8(8):2793–2795. doi: 10.1016/j.jaip.2020.06.046Mira E, Yarce OA, Ortega C et al. Rapid recovery of a SARS-CoV-2-infected X-linked agammaglobulinemia patient after infusion of COVID-19 convalescent plasma. J Allergy Clin Immunol Pract 2020 Sep;8(8):2793–2795. doi: 10.1016/j.jaip.2020.06.046Nguyen FT, van den Akker T, Lally K et al. Transfusion reactions associated with COVID-19 convalescent plasma therapy for SARS-CoV-2. Transfusion 2021 Jan;61(1):78–93. doi: 10.1111/trf.16177Nguyen FT, van den Akker T, Lally K et al. Transfusion reactions associated with COVID-19 convalescent plasma therapy for SARS-CoV-2. Transfusion 2021 Jan;61(1):78–93. doi: 10.1111/trf.16177O'Donnell MR, Grinsztejn B, Cummings MJ, et al. A randomized, double-blind, controlled trial of convalescent plasma in adults with severe COVID-19. medRxiv 2021.03.12.21253373; doi: https://doi.org/10.1101/2021.03.12.21253373O'Donnell MR, Grinsztejn B, Cummings MJ, et al. A randomized, double-blind, controlled trial of convalescent plasma in adults with severe COVID-19. medRxiv 2021.03.12.21253373; doi: https://doi.org/10.1101/2021.03.12.21253373Senefeld JW, Klassen SA, Ford SK et al. Therapeutic use of convalescent plasma in COVID-19 patients with immunodeficiency. medRxiv 2020.11.08.20224790; doi: https://doi.org/10.1101/2020.11.08.20224790Senefeld JW, Klassen SA, Ford SK et al. Therapeutic use of convalescent plasma in COVID-19 patients with immunodeficiency. medRxiv 2020.11.08.20224790; doi: https://doi.org/10.1101/2020.11.08.20224790Simonovich VA, Burgos Pratx LD, Scibona P et al. A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia. N Engl J Med 2021 Feb 18;384(7):619–629. doi: 10.1056/NEJMoa2031304Simonovich VA, Burgos Pratx LD, Scibona P et al. A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia. N Engl J Med 2021 Feb 18;384(7):619–629. doi: 10.1056/NEJMoa2031304Tarhini H, Recoing A, Bridier-Nahmias A et al. Long term SARS-CoV-2 infectiousness among three immunocompromised patients: from prolonged viral shedding to SARS-CoV-2 superinfection. J Infect Dis 2021 Feb 8:jiab075. doi: 10.1093/infdis/jiab075. Epub ahead of printTarhini H, Recoing A, Bridier-Nahmias A et al. Long term SARS-CoV-2 infectiousness among three immunocompromised patients: from prolonged viral shedding to SARS-CoV-2 superinfection. J Infect Dis 2021 Feb 8:jiab075. doi: 10.1093/infdis/jiab075. Epub ahead of printThe RECOVERY Collaborative Group, Peter W Horby, Lise Estcourt et al. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. medRxiv 2021.03.09.21252736; doi: https://doi.org/10.1101/2021.03.09.21252736The RECOVERY Collaborative Group, Peter W Horby, Lise Estcourt et al. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. medRxiv 2021.03.09.21252736; doi: https://doi.org/10.1101/2021.03.09.21252736Van Damme KFA, Tavernier S, Van Roy N et al. Case Report: Convalescent Plasma, a Targeted Therapy for Patients with CVID and Severe COVID-19. Front Immunol 2020 Nov 20;11:596761. doi: 10.3389/fimmu.2020.596761Van Damme KFA, Tavernier S, Van Roy N et al. Case Report: Convalescent Plasma, a Targeted Therapy for Patients with CVID and Severe COVID-19. Front Immunol 2020 Nov 20;11:596761. doi: 10.3389/fimmu.2020.596761Singer M, Deutschman CS, Seymour CW et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016 Feb 23;315(8):801–810. doi: 10.1001/jama.2016.0287Singer M, Deutschman CS, Seymour CW et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016 Feb 23;315(8):801–810. doi: 10.1001/jama.2016.0287Vincent JL, Lefrant JY, Kotfis K et al. Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP). Intensive Care Med 2018; 44:337–344. doi: 10.1007/s00134-017-5043-2 48. Meyer N, Harhay MO, Small DS et al. Temporal trends in incidence, sepsis-related mortality, and hospital-based acute care after sepsis. Crit Care Med 2018; 46:354–360. doi: 10.1097/ccm.0000000000002872Vincent JL, Lefrant JY, Kotfis K et al. Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP). Intensive Care Med 2018; 44:337–344. doi: 10.1007/s00134-017-5043-2 48. Meyer N, Harhay MO, Small DS et al. Temporal trends in incidence, sepsis-related mortality, and hospital-based acute care after sepsis. Crit Care Med 2018; 46:354–360. doi: 10.1097/ccm.0000000000002872Meyer N, Harhay MO, Small DS et al. Temporal trends in incidence, sepsis-related mortality, and hospital-based acute care after sepsis. Crit Care Med 2018; 46:354–360. doi: 10.1097/ccm.000000000000287249.Meyer N, Harhay MO, Small DS et al. Temporal trends in incidence, sepsis-related mortality, and hospital-based acute care after sepsis. Crit Care Med 2018; 46:354–360. doi: 10.1097/ccm.000000000000287249.Fleischmann C, Scherag A, Adhikari NK et al. Assessment of global incidence and mortality of hospital-treated sepsis. current estimates and limitations. Am J Respir Crit Care Med 2016; 193:259–272. doi: 10.1164/rccm.201504-0781OCFleischmann C, Scherag A, Adhikari NK et al. Assessment of global incidence and mortality of hospital-treated sepsis. current estimates and limitations. Am J Respir Crit Care Med 2016; 193:259–272. doi: 10.1164/rccm.201504-0781OCZahar JR,Timsit JF, Garrouste-Orgeas M et al. Outcomes in severe sepsis and patients with septic shock: pathogen species and infection sites are not associated with mortality. Crit Care Med 2011; 39:1886–1895. doi: 10.1097/CCM.0b013e31821b827cZahar JR,Timsit JF, Garrouste-Orgeas M et al. Outcomes in severe sepsis and patients with septic shock: pathogen species and infection sites are not associated with mortality. Crit Care Med 2011; 39:1886–1895. doi: 10.1097/CCM.0b013e31821b827cBlanco J, Muriel-Bombín A, Sagredo V et al. Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care (2008) 12:R158. doi: 10.1186/cc7157Blanco J, Muriel-Bombín A, Sagredo V et al. Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care (2008) 12:R158. doi: 10.1186/cc7157Southeast Asia Infectious Disease Clinical Research Network. Causes and outcomes of sepsis in southeast Asia: a multinational multicentre cross-sectional study. Lancet Glob Health (2017) 5:e157–167. doi: 10.1016/s2214-109x(17)30007-4Southeast Asia Infectious Disease Clinical Research Network. Causes and outcomes of sepsis in southeast Asia: a multinational multicentre cross-sectional study. Lancet Glob Health (2017) 5:e157–167. doi: 10.1016/s2214-109x(17)30007-4Attaway AH, Scheraga RG, Bhimraj A et al. Severe covid-19 pneumonia: pathogenesis and clinical management. BMJ 2021; 372 :n436 doi:10.1136/bmj.n436Attaway AH, Scheraga RG, Bhimraj A et al. Severe covid-19 pneumonia: pathogenesis and clinical management. BMJ 2021; 372 :n436 doi:10.1136/bmj.n436Chen G, Wu D, Guo W et al. Clinical and immunologic features in severe and moderate Coronavirus Disease 2019. J Clin Invest (2020) 130:2620–2629. 10.1101/2020.02.16.20023903Chen G, Wu D, Guo W et al. Clinical and immunologic features in severe and moderate Coronavirus Disease 2019. J Clin Invest (2020) 130:2620–2629. 10.1101/2020.02.16.20023903Gao Y, Li T, Han M et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol (2020) 92:791–796. 10.1002/jmv.257701-6Gao Y, Li T, Han M et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol (2020) 92:791–796. 10.1002/jmv.257701-6Braciale T, Hahn Y. Immunity to viruses. Immunol Rev 2013; 255:10.1111/imr.12109.10.1111/imr.12109Braciale T, Hahn Y. Immunity to viruses. Immunol Rev 2013; 255:10.1111/imr.12109.10.1111/imr.12109Tanaka T, Narazaki M, Kishimoto T. Immunotherapeutic implications of IL-6 blockade for cytokine storm. Immunotherapy 2016;8(8):959–970Tanaka T, Narazaki M, Kishimoto T. Immunotherapeutic implications of IL-6 blockade for cytokine storm. Immunotherapy 2016;8(8):959–970Hunter CA, Jones SA. IL-6 as a keystone cytokine in health and disease. Nat Immunol 2015;16(5):448–457Hunter CA, Jones SA. IL-6 as a keystone cytokine in health and disease. Nat Immunol 2015;16(5):448–457Xinjuan Sun, Tianyuan Wang, Dayong Cai et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine Growth Factor Rev 2020 Jun; 53: 38–42. 10.1016/j. cytogfr.2020.04.002Xinjuan Sun, Tianyuan Wang, Dayong Cai et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine Growth Factor Rev 2020 Jun; 53: 38–42. 10.1016/j. cytogfr.2020.04.002Weber A, Wasiliew P, Kracht M. Interleukin-1beta (IL- 1beta) processing pathway. Sci Signal 2010 Jan 19;3(105):cm2. doi: 10.1126/scisignal.3105cm2. PMID: 2008623Weber A, Wasiliew P, Kracht M. Interleukin-1beta (IL- 1beta) processing pathway. Sci Signal 2010 Jan 19;3(105):cm2. doi: 10.1126/scisignal.3105cm2. PMID: 2008623Jamilloux Y, Henry T, Belot A et al. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anticytokine interventions. Autoimmun Rev 2020 Jul;19(7):102567. doi: 10.1016/j.autrev.2020.102567Jamilloux Y, Henry T, Belot A et al. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anticytokine interventions. Autoimmun Rev 2020 Jul;19(7):102567. doi: 10.1016/j.autrev.2020.102567Idriss HT, Naismith JH. TNF alpha and the TNF receptor superfamily: structure-function relationship(s). Microsc Res Tech 2000 Aug 1;50(3):184–195. doi: 10.1002/1097-0029(20000801)50:3<184::AID-JEMT2>3.0.CO;2-HIdriss HT, Naismith JH. TNF alpha and the TNF receptor superfamily: structure-function relationship(s). Microsc Res Tech 2000 Aug 1;50(3):184–195. doi: 10.1002/1097-0029(20000801)50:3<184::AID-JEMT2>3.0.CO;2-HCole L, Bellomo R, Journois D et al. High-volume haemofiltration in human septic shock. Intensive Care Med 2001 Jun; 27(6): 978–986. doi: 10.1007/s001340100963Cole L, Bellomo R, Journois D et al. High-volume haemofiltration in human septic shock. Intensive Care Med 2001 Jun; 27(6): 978–986. doi: 10.1007/s001340100963Honore PM, Jamez J, Wauthier M et al. Prospective evaluation of short-term, high-volume iso-volemic hemofiltration on the hemodynamic course and outcome in patients with intractable circulatory failure resulting from septic shock. Crit Care Med 2000 Nov; 28(11): 3581–3587. doi: 10.1097/00003246-200011000-00001Honore PM, Jamez J, Wauthier M et al. Prospective evaluation of short-term, high-volume iso-volemic hemofiltration on the hemodynamic course and outcome in patients with intractable circulatory failure resulting from septic shock. Crit Care Med 2000 Nov; 28(11): 3581–3587. doi: 10.1097/00003246-200011000-00001Tapia P, Chinchon E, Morales D et al. Effectiveness of short-term 6-hour high-volume hemofiltration during refracto-ry severe septic shock. J Trauma Acute Care Surg 2012 May; 72(5): 1228–1238. doi: 10.1097/TA.0b013e318248bc6cTapia P, Chinchon E, Morales D et al. Effectiveness of short-term 6-hour high-volume hemofiltration during refracto-ry severe septic shock. J Trauma Acute Care Surg 2012 May; 72(5): 1228–1238. doi: 10.1097/TA.0b013e318248bc6cRatanarat R, Brendolan A, Piccinni P et al. Pulse highvolume haemofiltration for treatment of severe sepsis: effects on hemodynamics and survival. Crit Care 2005 Aug; 9(4):R294–302. doi: 10.1186/cc3529Ratanarat R, Brendolan A, Piccinni P et al. Pulse highvolume haemofiltration for treatment of severe sepsis: effects on hemodynamics and survival. Crit Care 2005 Aug; 9(4):R294–302. doi: 10.1186/cc3529Joannes-Boyau O, Honorу PM, Perez P et al. High- volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med 2013 Sep; 39(9): 1535–1546. doi: 10.1007/s00134-013-2967-zJoannes-Boyau O, Honorу PM, Perez P et al. High- volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med 2013 Sep; 39(9): 1535–1546. doi: 10.1007/s00134-013-2967-zBorthwick EM, Hill CJ, Rabindranath KS et al. High-volume haemofiltration for sepsis in adults. Cochrane Database Syst Rev 2017 Jan; 1:CD008075. doi: 10.1002/14651858.CD008075.pub3Borthwick EM, Hill CJ, Rabindranath KS et al. High-volume haemofiltration for sepsis in adults. Cochrane Database Syst Rev 2017 Jan; 1:CD008075. doi: 10.1002/14651858.CD008075.pub3Clark E, Molnar AO, Joannes-Boyau O et al. High-volume hemofiltration for septic acute kidney injury: a systematic review and meta-analysis. Crit Care 2014 Jan; 18(1):R7. doi: 10.1186/cc13184Clark E, Molnar AO, Joannes-Boyau O et al. High-volume hemofiltration for septic acute kidney injury: a systematic review and meta-analysis. Crit Care 2014 Jan; 18(1):R7. doi: 10.1186/cc13184Morgera S, Haase M, Kuss T et al. Pilot study on the effects of high cutoff hemofiltra-tion on the need for norepinephrine in septic patients with acute renal failure. Crit Care Med 2006 Aug; 34(8): 2099–2104. doi: 10.1097/01.CCM.0000229147.50592.F9Morgera S, Haase M, Kuss T et al. Pilot study on the effects of high cutoff hemofiltra-tion on the need for norepinephrine in septic patients with acute renal failure. Crit Care Med 2006 Aug; 34(8): 2099–2104. doi: 10.1097/01.CCM.0000229147.50592.F9Morgera S, Rocktäschel J, Haase M et al. Intermittent high permeability hemofiltration in septic patients with acute renal failure. Intensive Care Med 2003 Nov; 29(11): 1989–1995. doi: 10.1007/s00134-003-2003-9Morgera S, Rocktäschel J, Haase M et al. Intermittent high permeability hemofiltration in septic patients with acute renal failure. Intensive Care Med 2003 Nov; 29(11): 1989–1995. doi: 10.1007/s00134-003-2003-9Atan R, Peck L, Prowle J et al. A Double-Blind Randomized Controlled Trial of High Cutoff Versus Standard Hemofiltration in Critically Ill Patients With Acute Kidney Injury. Crit Care Med 2018 Oct; 46(10):e988–994. doi: 10.1097/CCM.0000000000003350Atan R, Peck L, Prowle J et al. A Double-Blind Randomized Controlled Trial of High Cutoff Versus Standard Hemofiltration in Critically Ill Patients With Acute Kidney Injury. Crit Care Med 2018 Oct; 46(10):e988–994. doi: 10.1097/CCM.0000000000003350Kade G, Lubas A, Rzeszotarska A et al. Effectiveness of High Cut-Off Hemofilters in the Removal of Selected Cyto-kines in Patients During Septic Shock Accompanied by Acute Kidney Injury-Preliminary Study. Med Sci Monit 2016 Nov; 22: 4338–4344. doi: 10.12659/MSM.896819Kade G, Lubas A, Rzeszotarska A et al. Effectiveness of High Cut-Off Hemofilters in the Removal of Selected Cyto-kines in Patients During Septic Shock Accompanied by Acute Kidney Injury-Preliminary Study. Med Sci Monit 2016 Nov; 22: 4338–4344. doi: 10.12659/MSM.896819Villa G, Chelazzi C, Morettini E et al. Organ dysfunction during continuous veno-venous high cut-off hemodialysis in patients with septic acute kidney injury: A prospective observational study. PLoS One 2017 Feb; 12(2):e0172039. doi: 10.1371/journal.pone.0172039Villa G, Chelazzi C, Morettini E et al. Organ dysfunction during continuous veno-venous high cut-off hemodialysis in patients with septic acute kidney injury: A prospective observational study. PLoS One 2017 Feb; 12(2):e0172039. doi: 10.1371/journal.pone.0172039Chelazzi C, Villa G, D’Alfonso MG et al. Hemodialysis with High Cut-Off Hemodialyzers in Patients with Multi-Drug Resistant Gram- Negative Sepsis and Acute Kidney Injury: A Retrospective, Case-Control Study. Blood Pu-rif 2016; 42(3): 186–193. doi: 10.1159/000446978Chelazzi C, Villa G, D’Alfonso MG et al. Hemodialysis with High Cut-Off Hemodialyzers in Patients with Multi-Drug Resistant Gram- Negative Sepsis and Acute Kidney Injury: A Retrospective, Case-Control Study. Blood Pu-rif 2016; 42(3): 186–193. doi: 10.1159/000446978Kim ST, Yamamoto C, Asabe H, Sato T, Takamiya T. Online haemodiafiltration: Effective removal of high molecular weight toxins and improvement in clinical manifestations of chronic haemodialysis patients. Nephrology 1996; 2(Suppl 1):S183–S186Kim ST, Yamamoto C, Asabe H, Sato T, Takamiya T. Online haemodiafiltration: Effective removal of high molecular weight toxins and improvement in clinical manifestations of chronic haemodialysis patients. Nephrology 1996; 2(Suppl 1):S183–S186Kaiser JP, Oppermann M, Gotze O et al. Significant reduction of factor D and immunosuppressive complement fragment Ba by hemofiltration. Blood Purif 1995; 13(6):314–321Kaiser JP, Oppermann M, Gotze O et al. Significant reduction of factor D and immunosuppressive complement fragment Ba by hemofiltration. Blood Purif 1995; 13(6):314–321Ward RA, Schmidt B, Hullin J et al. A comparison of on-line hemodiafiltration and high-flux hemodialysis: A prospective clinical study. J Am Soc Nephrol 2000; 11(12):2344–2350Ward RA, Schmidt B, Hullin J et al. A comparison of on-line hemodiafiltration and high-flux hemodialysis: A prospective clinical study. J Am Soc Nephrol 2000; 11(12):2344–2350Rama I, Llaudo I, Fontova P et al. Online Haemodiafiltration Improves Inflammatory State in Dialysis Patients: A Longitudinal Study. PLoS One 2016 Oct 26;11(10):e0164969. doi: 10.1371/journal.pone.0164969Rama I, Llaudo I, Fontova P et al. Online Haemodiafiltration Improves Inflammatory State in Dialysis Patients: A Longitudinal Study. PLoS One 2016 Oct 26;11(10):e0164969. doi: 10.1371/journal.pone.0164969Pizzarelli F, Cantaluppi V, Panichi V et al. Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study "Hephaestus". J Nephrol 2021 Feb 9. doi: 10.1007/s40620-020-00943-6Pizzarelli F, Cantaluppi V, Panichi V et al. Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study "Hephaestus". J Nephrol 2021 Feb 9. doi: 10.1007/s40620-020-00943-6Morris C, Gray L, Giovannelli M. Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations. J Intensive Care Soc 2015 Aug;16(3):257–264. doi: 10.1177/1751143715574855Morris C, Gray L, Giovannelli M. Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations. J Intensive Care Soc 2015 Aug;16(3):257–264. doi: 10.1177/1751143715574855Zuccari S, Damiani E, Domizi R et al. Changes in Cytokines, Haemodynamics and Microcirculation in Patients with Sepsis/Septic Shock Undergoing Continuous Renal Replacement Therapy and Blood Purification with CytoSorb. Blood Purif 2020;49 (1–2):107–113. doi: 10.1159/000502540Zuccari S, Damiani E, Domizi R et al. Changes in Cytokines, Haemodynamics and Microcirculation in Patients with Sepsis/Septic Shock Undergoing Continuous Renal Replacement Therapy and Blood Purification with CytoSorb. Blood Purif 2020;49 (1–2):107–113. doi: 10.1159/000502540Knaup H, Stahl K, Schmidt BMW et al. Early therapeutic plasma exchange in septic shock: a prospective open-label nonrandomized pilot study focusing on safety, hemodynamics, vascular barrier function, and biologic markers. Crit Care 2018 Oct 30;22(1):285. doi: 10.1186/s13054-018-2220-9Knaup H, Stahl K, Schmidt BMW et al. Early therapeutic plasma exchange in septic shock: a prospective open-label nonrandomized pilot study focusing on safety, hemodynamics, vascular barrier function, and biologic markers. Crit Care 2018 Oct 30;22(1):285. doi: 10.1186/s13054-018-2220-9Sanford KW, Balogun RA. Extracorporeal photopheresis: clinical use so far. J Clin Apher 2012;27(3):126–131. doi: 10.1002/jca.21217Sanford KW, Balogun RA. Extracorporeal photopheresis: clinical use so far. J Clin Apher 2012;27(3):126–131. doi: 10.1002/jca.21217Reeves JH, Butt WW, Shann F, Layton JE, Stewart A, Waring PM, Presneill JJ. Continuous plasmafiltration in sepsis syndrome. Plasmafiltration in Sepsis Study Group. Crit Care Med 1999 Oct;27(10):2096–2104. doi: 10.1097/00003246-199910000-00003Reeves JH, Butt WW, Shann F, Layton JE, Stewart A, Waring PM, Presneill JJ. Continuous plasmafiltration in sepsis syndrome. Plasmafiltration in Sepsis Study Group. Crit Care Med 1999 Oct;27(10):2096–2104. doi: 10.1097/00003246-199910000-00003Busund R, Koukline V, Utrobin U, Nedashkovsky E. Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial. Intensive Care Med 2002 Oct;28(10):1434–1439. doi: 10.1007/s00134-002-1410-7Busund R, Koukline V, Utrobin U, Nedashkovsky E. Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial. Intensive Care Med 2002 Oct;28(10):1434–1439. doi: 10.1007/s00134-002-1410-7Rimmer E, Houston BL, Kumar A et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care 2014 Dec 20;18(6):699. doi: 10.1186/s13054-014-0699-2Rimmer E, Houston BL, Kumar A et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care 2014 Dec 20;18(6):699. doi: 10.1186/s13054-014-0699-2Ronco C, Brendolan A, D'Intini V, Ricci Z, Lou WM, Bellomo R. Coupled plasma filtration adsorption: rationale, technical development and early clinical experience. Blood Purif 2003;21(6):409–416. doi: 10.1159/000073444Ronco C, Brendolan A, D'Intini V, Ricci Z, Lou WM, Bellomo R. Coupled plasma filtration adsorption: rationale, technical development and early clinical experience. Blood Purif 2003;21(6):409–416. doi: 10.1159/000073444Livigni S, Bertolini G, Rossi C et al. Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: a multicenter randomised controlled clinical trial. BMJ Open 2014;4(1):1–10. doi: 10.1136/bmjopen-2013-003536Livigni S, Bertolini G, Rossi C et al. Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: a multicenter randomised controlled clinical trial. BMJ Open 2014;4(1):1–10. doi: 10.1136/bmjopen-2013-003536

The authors declare that there are no conflicts of interest present.