Extracorporal hemocorrection methods for COVID-19: are there outlooks?
A. Sh. Rumyantsev,
M. Kh. Khasun,
I. Yu. Panina,
N. Yu. Korosteleva,
V. A. Shurakova,
G. A. Zemchenkov https://doi.org/10.36485/1561-6274-2021-25-4-95-106
Abstract
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.
About the Authors
A. Sh. Rumyantsev
Saint Petersburg State University; First Saint Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
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
M. Kh. Khasun
First Saint Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
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
I. Yu. Panina
First Saint Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
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
N. Yu. Korosteleva
First Saint Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
Natalya Yu. Korosteleva, MD, PhD, Research Institute of Nephrology, senior researcher
197022, Saint Petersburg, L'va Tolstogo str. 6-8
Phone: +7 (911) 9184549
V. A. Shurakova
First Saint Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
Vera A. Shurakova, MD, Department of Propaedeutics of Internal Medicine
197022, Saint Petersburg, L'va Tolstogo, str. 6-8
Phone: (812) 906-97-53
G. A. Zemchenkov
BBraun Avitum Russland Clinics
Russian Federation
Russian Federation
Gennadiy A. Zemchenkov, MD
Phone: +7(812) 334-76-30
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Rumyantsev A.Sh., Khasun M.Kh., Panina I.Yu., Korosteleva N.Yu., Shurakova V.A., Zemchenkov G.A. Extracorporal hemocorrection methods for COVID-19: are there outlooks? Nephrology (Saint-Petersburg). 2021;25(4):95-106. (In Russ.) https://doi.org/10.36485/1561-6274-2021-25-4-95-106
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