- COVID-19 Infection leads to Cytokine Storm: Experts Say
- 67% of hospitalized COVID-19 patients may present with additional organ dysfunction syndromes, other than lungs that may be induced by a high level of circulating cytokines
(www.arya-tv.com)Cytokine Storm appears to be common in severe cases of COVID-19. This is an umbrella term wherein a massive release of cytokines; i.e. immune proteins that may lead to multi-organ involvement. This uncontrolled reaction can occur in a variety of conditions, including infections, organ damage and autoimmune disorders. Cytokine Storm can be life-threatening and may require urgent intervention.
Dr. Narayan Prashad, Nephrologist, SGPGI, Lucknow, said, “According to Chinese researchers with much experience of managing COVID-19 patients, Continuous Renal Replacement Therapy (CRRT) is not just renal support, but also helps in curbing the cytokine storm and multi-organ support in critically ill patients. In situations where patients may not be able to sustain rapid changes in body fluid balance and metabolic fluctuations and in situations where other extracorporeal therapies are required like invasive ventilator support, continuous RRT can be used as an integrated system and are preferred over parallel systems, as was highlighted by a small retrospective study in COVID-19 patients requiring invasive mechanical ventilation, where CRRT was associated with a significant reduction in mortality (74.6% Vs. 54.5% p=0.032) than those treated without CRRT.
“As per the recommendation of American Society of Nephrology and in the COVID-19 pandemic scenario, the CRRT maybe one of the preferred modalities, especially for those who have hemodynamic instability. CRRT is a blood purification therapy applied for 24 hours a day. At present, among the other therapies being used, CRRT is beneficial to maintain volume balance, hemodynamic stability and to improve the clearance efficiency of middle-sized molecules such as cytokines especially when used with adsorptive filters which can help with improved clearance of cytokines from circulation”, said Dr Himanshu Reddy, Intensivist, KGMU, Lucknow.
He further added, “One such adsorptive filter available in India is Oxiris, which amidst COVID-19 pandemic crisis has also received emergency use authorization from the US Food and Drug Administration (FDA) for COVID-19 treatment. Moreover, this filter set can be used to perform multiple blood purification therapies simultaneously, including cytokine removal or/and CRRT.”
