Rationale of using CytoSorb Therapy
The exacerbated inflammatory response typical of the pathophysiological picture of pneumonia, which is expressed through a “cytokine storm“, well known in literature, seems to be confirmed also in the context of COVID-19, and seems to lead to a “capillary leak syndrome”, leading in the most critical patients to a state of acute respiratory failure, pulmonary edema, and can quickly evolve into a picture of ARDS (Acute Respiratory Distress Syndrome) or sepsis.
In addition, further complications may occur and the clinical picture could evolve to consequences, such as shock, acute renal failure and MOF (Multiple Organ Failure).
Consequently, CytoSorb Therapy, designed to remove cytokines and other circulating mediators from the blood, might represent a control to support and probably prevent the serious complications in critically ill COVID-19 patients.
Experience in Treating Patients with COVID-19 infection
To date, more than 65 critically ill patients with COVID-19 infection have been treated with CytoSorb as supportive therapy for cytokine cascade remodulation in various centers in China, Germany and, above all, Italy.
Although formal clinical data are not yet available due to the extraordinary circumstances, the experience of many Italian centers in recent weeks has allowed to observe encouraging results in more severe COVID-19 patients with severe respiratory syndromes, ARDS and/or multi-organ dysfunction, where the control of the exacerbated inflammatory response seems to have promoted the hemodynamic stabilization of patients and the improvement of respiratory parameters. Modulation of the “cytokine storm” seems to result in endothelial protection, which can be translated into a reduction of the “capillary leak syndrome” and, consequently, in better control of oedema formation and lung infiltration.
The experience in the most serious cases seems to confirm the feasibility of combined treatment with monoclonal anti IL-6 drug, as Tocilizumab, as previously highlighted in the treatment of Cytokine Release Syndrome, contributing synergistically to cytokine reduction. It should be noted that hemoperfusion with CytoSorb can be used in combination with monoclonal therapy, during or after, according to existing protocols in the centers, without interfering with it.
In view of the rationale and the results, albeit preliminary, that have emerged in the recent months in the hospitals where the treatment was introduced, CytoSorb has achieved FDA Emergency Use Authorization for Use in Patients with COVID-19 Infection