Dr. Hussein Bagh: showed that cytokine storm leads to high morbidity and mortality on COVID-19 patients. The infection progresses has three stages, the early infection(stage-I), pulmonary phase (stage-II) and the hyperinflammation phase (stage-III). Stage II and III present with host inflammatory response with cytokine storm which play a key role in ARDS. The benefits of cytokine absorber such as HA330 is to:
- Reduce the cytokine levels and this may lead to improve kidney and lung function
- Improve hemodynamic status (MAP)
- Improve 28-day survival rate
The Doctor concluded his experience from M.P Shah Hospital-Kenya with 14 critical COVID-19 patients used HA330 cartridge as follow:
- Hemoperfusion is promising modality of treatment for severe disease
- Data locally shows good positive outcomes for hemoperfusion.
Dr. Anthony J. O. Were: demonstrated that:
- COVID-19 caused by a novel coronavirus structurally related to the virus that causes (SARS).
- Acute kidney injury (AKI) requiring acute renal replacement therapy (RRT) occurs in approximately 15% of all ICU admissions. And the incidence is increased in the setting of acute respiratory distress syndrome (ARDS).
The Possible mechanisms of developing AKI in COVID- patients including the pre-renal, tubular, Interstitial, vascular, glomerular, post-renal factors. The doctor also explained the care strategies of AKI and ESKD in ICU, the modalities of renal replacement therapy and so on.
Prof. Claudio Ronco: during his speech revealed that cytokine storm considered one of the important pathways of AKI.
- The most efficient method to directly adsorb cytokines in the blood is when circulated in special neutro-macroporous resin placed in special cartridge such as HA380 which we tested in our hospital in different situation, it can be placed before and after the dialyzer or utilized as an isolated system.
Case of COVID-19 was admitted with fever, hypotension, respiratory failure, and mechanical ventilation, at day 3 patient was with very high levels of IL-6 and inflammatory markers and hypercoagulability, after treated with 3 consecutive days of HA380, patient displayed:
- Hemodynamic stabilization
- Normalization of cytokine levels
- Decreased inflammatory parameters
- Improved pulmonary exchanges
HA380 also can be utilized in conjunction with ECMO to prevent further cytokine release induced by extracorporeal membrane oxygenation circuit.
Dr. Khalida Soki: illustrated that COVID-19 primarily presents as an acute respiratory illness, with interstitial and alveolar pneumonia. Higher plasma cytokine levels (interleukin IL-2, IL-6, IL-10, GCSF, interferon-inducing protein-10, monocyte chemoattractant protein 1, macrophage inflammatory protein-1a, tumour necrosis factor α) were present in patients requiring intensive care unit. The doctor briefly introduced the histopathological findings and the treatment procedures for COVID-19 patients including the properties of ideal dialysis modality.
Dr. Ibrahim Mohammed: reported the using of HA330 on severe acute pancreatitis with extensive necrosis of the pancreas >60%, temperature 39-40 0C, ARDS and AKI, the HA330 treatment in addition to standard treatment resulted in:
- Improving the symptoms and signs
- Reducing the inflammatory markers
- Reducing the inotropes used
- Improving the general condition of the patients.