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Volume  1 (2022)
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VOLUME 1 , ISSUE 2 ( May-August, 2022 ) > List of Articles

REVIEW ARTICLE

Hemoadsorption (CytoSorb®) in Management of Cytokine Storm and Implication in COVID-19 Pandemic

Harish M Maheshwarappa, Shreedhar S Joshi, Robert James Premkumar, Shivangi Mishra, Shiva Prasad

Keywords : Blood filtration, Coronavirus disease 2019, Cytokine storm, CytoSorb®, Hemoadsorption

Citation Information : Maheshwarappa HM, Joshi SS, Premkumar RJ, Mishra S, Prasad S. Hemoadsorption (CytoSorb®) in Management of Cytokine Storm and Implication in COVID-19 Pandemic. 2022; 1 (2):61-67.

DOI: 10.5005/jp-journals-10089-0019

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Introduction: Sepsis-related deaths contribute up to 20% of all global deaths, with the highest-burden from sub-Saharan Africa and Southeast Asia. Cytokines are the mediators of organ dysfunction in systemic inflammatory response syndrome (SIRS) across varied etiologies, including sepsis. The imbalance of pro-and anti-inflammatory cytokines continues to be the crux of the pathophysiology of organ dysfunction in septic shock. Therapies to treat cytokines either by antagonizing them or filtering them out of the body are evolving. Hemoadsorption is a process of filtering out cytokines and other metabolites involved in SIRS by surface adsorption. Materials and methods: We searched for terms–Hemoadsorption, CytoSorb, in PubMed and Google Scholar. We enrolled manuscripts with patients at Indian Centers for review. We extend our review of cytokine storm in COVID-19 and the utility of CytoSorb as an adjuvant in the management of septic shock in COVID-19. Conclusion: Severe acute respiratory syndrome coronavirus -2 (SARS-CoV-2) infection causing COVID-19 (Coronavirus disease - 2019) pandemic has affirmed cytokine storm as the principal pathology causing morbidity and mortality. Management strategies are mostly supportive since specific antiviral therapy is still in the incipient stage. Cytokine adsorption is being used across most Western countries in COVID-19 septic shock. COVID-19 with cytokine storm as its main pathology is a suitable substrate for the use of CytoSorb. COVID-19 patients with elevated cytokine levels can be offered CytoSorb® hemoadsorption along with other supportive therapies.

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