Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients
Abstract Severe COVID-19 infection results in significant immune dysregulation resulting from excessive recruitment and activation of neutrophils. The aim of this study was to confirm feasibility, initial safety and detect signal of efficacy of a non-propriety device delivered using an intermittent...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-21944-4 |
| _version_ | 1811215913478782976 |
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| author | Sandrine Lemoine Jarrin Penny Douglas D. Fraser Fabio R. Salerno Justin Dorie Tanya Tamasi Robert Arntfield Andrew House Marat Slessarev Christopher W. McIntyre |
| author_facet | Sandrine Lemoine Jarrin Penny Douglas D. Fraser Fabio R. Salerno Justin Dorie Tanya Tamasi Robert Arntfield Andrew House Marat Slessarev Christopher W. McIntyre |
| author_sort | Sandrine Lemoine |
| collection | DOAJ |
| description | Abstract Severe COVID-19 infection results in significant immune dysregulation resulting from excessive recruitment and activation of neutrophils. The aim of this study was to confirm feasibility, initial safety and detect signal of efficacy of a non-propriety device delivered using an intermittent extra-corporeal system (LMOD) allowing leucocytes modulation in the setting of Severe COVID-19 infection. Twelve patients were recruited. Inclusion criteria were > 18 years age, confirmed COVID-19, acute respiratory distress syndrome requiring mechanical support and hypotension requiring vasopressor support. Primary end point was vasopressor requirements (expressed as epinephrine dose equivalents) and principle secondary endpoints related to safety, ability to deliver the therapy and markers of inflammation assessed over five days after treatment initiation. LMOD treatment appeared safe, defined by hemodynamic stability and no evidence of white cell number depletion from blood. We demonstrated a significant decrease in vasopressor doses (−37%, p = 0.02) in patients receiving LMOD therapy (despite these patients having to tolerate an additional extracorporeal intermittent therapy). Vasopressor requirements unchanged/increasing in control group (+ 10%, p = 0.48). Although much about the use of this therapy in the setting of severe COVID-19 infection remains to be defined (e.g. optimal dose and duration), this preliminary study supports the further evaluation of this novel extracorporeal approach. |
| first_indexed | 2024-04-12T06:30:10Z |
| format | Article |
| id | doaj.art-5636309efec8404a896dbcf2701c727d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T06:30:10Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-5636309efec8404a896dbcf2701c727d2022-12-22T03:44:02ZengNature PortfolioScientific Reports2045-23222022-11-011211810.1038/s41598-022-21944-4Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patientsSandrine Lemoine0Jarrin Penny1Douglas D. Fraser2Fabio R. Salerno3Justin Dorie4Tanya Tamasi5Robert Arntfield6Andrew House7Marat Slessarev8Christopher W. McIntyre9The Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioLawson Health Research InstituteThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioLawson Health Research InstituteDivision of Nephrology, Schulich School of Medicine & Dentistry, Western OntarioThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioThe Lilibeth Caberto Kidney Clinical Research Unit (KCRU), Kidney Clinical Research Unit Room ELL-101, London Health Sciences, University of Western OntarioAbstract Severe COVID-19 infection results in significant immune dysregulation resulting from excessive recruitment and activation of neutrophils. The aim of this study was to confirm feasibility, initial safety and detect signal of efficacy of a non-propriety device delivered using an intermittent extra-corporeal system (LMOD) allowing leucocytes modulation in the setting of Severe COVID-19 infection. Twelve patients were recruited. Inclusion criteria were > 18 years age, confirmed COVID-19, acute respiratory distress syndrome requiring mechanical support and hypotension requiring vasopressor support. Primary end point was vasopressor requirements (expressed as epinephrine dose equivalents) and principle secondary endpoints related to safety, ability to deliver the therapy and markers of inflammation assessed over five days after treatment initiation. LMOD treatment appeared safe, defined by hemodynamic stability and no evidence of white cell number depletion from blood. We demonstrated a significant decrease in vasopressor doses (−37%, p = 0.02) in patients receiving LMOD therapy (despite these patients having to tolerate an additional extracorporeal intermittent therapy). Vasopressor requirements unchanged/increasing in control group (+ 10%, p = 0.48). Although much about the use of this therapy in the setting of severe COVID-19 infection remains to be defined (e.g. optimal dose and duration), this preliminary study supports the further evaluation of this novel extracorporeal approach.https://doi.org/10.1038/s41598-022-21944-4 |
| spellingShingle | Sandrine Lemoine Jarrin Penny Douglas D. Fraser Fabio R. Salerno Justin Dorie Tanya Tamasi Robert Arntfield Andrew House Marat Slessarev Christopher W. McIntyre Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients Scientific Reports |
| title | Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients |
| title_full | Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients |
| title_fullStr | Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients |
| title_full_unstemmed | Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients |
| title_short | Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients |
| title_sort | initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill covid 19 infected patients |
| url | https://doi.org/10.1038/s41598-022-21944-4 |
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